Clinical Cases Homeopathy Papers

“The Depth of Homoeopathy”

Dr. Rajan Sankaran gives insights into the development of the Sensation Method, it’s relation to case taking and potency selection and gives a beautiful cured case of orbital hemangioma.

From the initial years of my practice I began to search for a method that would yield consistent and successful results in every case. No one person can know everything, and my endeavor for better and more consistent results is a continuing process.

In the twenty-one years of my practice this process has resulted in a shift from mechanically repertorizing cases after selecting a few characteristic symptoms, to using mental and general symptoms; from there to understanding the central disturbance, perceiving the mental state and unearthing the concept of disease as a delusion and later to a deeper understanding of miasms and the kingdom classification, and finally developing a system of prescribing where all these concepts fit into place, to discovering the common sensation in each of the plant families and more recently to an understanding of various levels of experience.

Studying the plant families has led me to a milestone in my understanding of disease; and my earlier concept of disease as a delusion and the subsequent emphasis on the mental state gave way to an understanding of disease as a Vital Sensation that was common to the mind and the body. This common disturbance seemed more representative of the disturbance of the Vital Force, than the Delusion had been. More recently this latter concept too has undergone some metamorphosis with the discovery of something deeper to the Vital Sensation, viz. energy.

With the emphasis on sensations it came to my notice that patients often used hand gestures to describe sensations. And as I started paying attention to these gestures I realized that these only sometimes were indicative of sensation; at other times they could indicate the delusion, and at still other times they were only patterns that could not be reduced to either a nervous or emotional experience.

Like sensations, these patterns too could not be localized in either the mind or the body; they were too general. Further, what the patient was conveying through these was mostly movement, sometimes together with form, shape, color and speed. These patterns seemed to me to be representative of energy. And the domain of energy was once again general and still deeper than sensation.

I realized then that the delusion had merely been one level along a spectrum of various levels. I was able to identify seven levels in all, and beginning from the most superficial to the deepest they are as follows:

1.Name
2. Fact
3. Emotion
4. Delusion
5. Sensation
6. Energy or Universal level
7. The Seventh Level

The concept of these levels is universally applicable, as is true with all of Homoeopathy. It indicates not only the level at which the patient experiences symptoms, but also the various levels of all human experience. Further human consciousness is in a state of continuous growth, and the levels are indicative of the evolution from the most superficial to the spiritual, which is the ultimate aim of mankind. Explained very briefly below are the concepts of Vital Sensation and The Levels, and an illustration of their application in Homoeopathy.

The concept of the Levels:

Let us understand the concept of the levels through the following example:

As children when we are taught to draw the first thing that we learn to draw is a line; then some shapes like triangles, squares and circles. Then we are taught to copy things we see around us: objects, houses, trees, people etc. As we progress we are taught to qualify the subject of our drawings: for example, a sad person or a happy person, a flowing river etc.

Next we are asked to create drawings out of our imaginations: scenes from nature, a marketplace, a picnic etc. Later some of us learn to abstract, and we are able to express our moods and experiences through different shapes, form and color. Our experiences may be mental or physical or spiritual, and these can be conveyed through the medium of abstract art.

One can see that our initial drawings of lines and shapes cannot convey anything; they have nothing more than a name attached to them. For example: this is a line, this is a circle etc. The next step where we are taught to copy has to do with fact; there are things that exist around us and we replicate them. In the third step we put in the adjectives or feelings or emotions.

In the fourth step we create situations out of our imagination; situations that may or may not exist, or situations we may have or have not experienced. This has to do with delusion. When we reach the stage where we can abstract we are able to convey our delusions, sensations (mental and physical) as well as describe some kind of energy in the form of patterns and shapes. In this way, in learning art we have progressed from what can be only named to something that has no name but only an energy pattern.

Similarly with Homoeopathy. The most superficial level at which Homoeopathy is practiced is pathological prescribing, or giving a remedy based on the diagnosis of the disease condition. (Level I: Name) At the next level of prescribing one takes into account symptoms of the disease. (Level II: Fact) Then comes prescribing on the emotional state of the patient. (Level III) Level IV or the level of Delusions is where my prescriptions were aimed at for many years. Then I discovered the level of Sensation (Level V) and finally that of Energy (Level VI).

The levels also apply to the experience of any event or phenomenon (For example: the sunrise or the Northern lights in the sky), or an art form (For example: music, painting, literature), any kind of human activity (For example: science, politics, medicine, sex, relationships) or a belief like religion the experience of all these can be at various levels. Let us look at the example of religion more closely.

For different people religion may be experienced and practiced to various depths. Or then a person may evolve over time in his religious practice and beliefs from the level of name to that of energy.

The most superficial experience of religion (at the level of name) is limited to simply identifying oneself as a Hindu or Catholic or Muslim etc.

At the factual level this experience is also superficial, being confined to daily prayers, rituals, attending mass or reading the holy book.

Taken one level deeper religion can be an emotional experience with feelings of joy, calm, security and dependence.

It could be the delusional need in a person who feels he is lost in the wilderness; religion could make him feel “found”.
Some persons may perceive sensations such as binding, or togetherness etc.

At the deepest level or in the abstract form it can be experienced as nothing but spiritual energy.

The Levels and Homoeopathy:

As with any phenomena the experience of the disease can also be at various levels. A patient with a very extensive cancer may have accepted his fate so that he experiences no emotions such as anxiety or fear or grief, but only symptoms related to his problem. For him the experience of his disease is no more than a fact; he has cancer, it is his fate and he has to accept it as a fact. On the other hand a young woman with rheumatoid arthritis may experience a great deal of anxiety about her future.

If you observe her or go through her case this anxiety will be the most prominent feature. One could say even that her disease is anxiety of the future rather than the arthritis, because she experiences the arthritis as anxiety. The pains will be experienced as anxiety, the limitation of movement will be experienced as anxiety. The level at which she experiences her disease is Level III (Emotions). Another young woman with a patch of eczema may have the fear that she will be shunned by society as a result of her problem. For her symptoms like itching and scaling, even though present, will not be as bothersome as this imaginary fear of being shunned. For her the eczema is experienced as a delusion, the level of experience being level IV.

A man with bronchial asthma may experience the sensation of being bound tightly, and this sensation will also emerge on the mental plane. Here what is prominent is a sensation that is common to the mind and the body. The asthma is experienced by him as a sensation of being bound tightly, and in other areas of his life he experiences the same sensation. His experience of his disease is at level V, the level of sensation. In a child with recurrent colds and coughs one may observe the child only running about the place continuously, moving about constantly and rapidly. This child may not even experience the cold and cough rather only the energy that compels him to keep running. His level of experience is that of energy, or level VI.

Having understood that each patient’s experience of the disease will be at any one of these levels the question that comes to one’s mind is, “Of what use is this concept in practice?” What will be most obvious to those who used the Delusion theory, and realized that it yielded better results than prescription based on mere collections of symptoms, is that the levels of sensation and energy are deeper and closer to the Vital Force.

Prescriptions based on sensations, and those that take into account the energy pattern experienced by the patient can yield far better results than did those based on Delusions. So how does one get to these deeper levels, how does one recognize sensation and energy, what sense do we make of these when attempting to understand the patient, and finally how does one use these to find the remedy?

Before we go to the process of getting to the deeper levels let us understand them some more. Firstly each of the levels is based on the one deeper to it. The seventh or the deepest level can be compared to an empty canvas on which some pattern or picture can take form. It forms the backdrop on which the Universe was created, on which the energy of the Universe is manifest. It is obvious just at the moment of conception, where something, a life or energy form, occurs from nothing, where creation has happened out of nothingness.

It is therefore the basis for energy. The level of energy in turn forms the basis for sensation, but itself lacks the sensation. Energy is represented by the way it moves. And for any individual the domain of experience of this energy is beyond mind and body; it is the domain of vitality or the Vital Force itself. And this experience is in the form of speed, movement, patterns, color etc. When this experience materializes from the domain of the material/spiritual Vital Force to that of the nerves which are distributed everywhere in the body, then it is perceived as a sensation. The nervous system connects the mind and the body and at this level the sensations experienced are general.

Let us take as an example the experience of listening to music. Music itself is pure energy. When a musical chord is struck some vibrations or patterns are created, and these are not only picked up by the nerves in the ear and experienced as pleasant sounds, but can also be transmitted everywhere else in the body and experienced as pleasant sensations. (Here, let us differentiate between general and local sensations. The sensations we are talking about at level V are general. While these are experienced on the somatic plane they are felt in more than one locality. Further, they are also experienced on the mental plane.

These are different from purely local sensations, which have no correspondences on the general and physical planes.) Similarly, sensation is the basis for delusion. If there is a sensation of heaviness all over it could give rise to the mental image or false perception of being under a heavy load. In turn, delusion becomes the basis for emotions, emotions for fact and fact for name. In this way each level is based on the next. In taking a case and understanding the patient, having gone past one level one can expect to find the next one emerging, till the deepest level is reached.

It is important and interesting to note that in each case, the deepest level the patient takes us to spontaneously, is the level at which he experiences all phenomena. This is his level of consciousness. In any case therefore, all relevant experiences, viz. the chief complaint, exciting cause, stress situations, dreams, interests and hobbies etc will be experienced by the patient at one and the same level. This is significant as far as the process of case taking is concerned, as well as in selecting the potency. Also from deep to superficial the extent of pathology increases, so that at the energy level there is the least pathology, whereas at the level of name one usually sees gross pathology.

The levels and potency selection:

Potency Physical symptoms experienced
– Level 1 (Gross pathology) 6C, 12C Diagnosis , Pathology
– Level 2 30C Local symptoms (Location, sensations,
modalities)
– Level 3 200C Concomitants, General effects of
Level 2
– Level 4 1M *N E I symptoms, cravings, sleep,
general modalities
– Level 5 10M General sensations, affections.
– Level 6 (Least pathology) 50M General movements and patterns

*NEI = Neuro-endocrine-immune axis.

Sensation is non-human specific:

Energy is universal and immaterial. All things, living and non-living, possess energy. Energy can be manifest in the form of different patterns, all part of a common, universal pool, yet each one with it’s own peculiar shape, direction, speed, form etc. Energy patterns are common to kingdoms, so that certain plants, animals and minerals can have the same energy patterns specific to them, yet all belonging to the common pool. The energy of any substance is that which is common to that substance and to the entire universe.

At the energy level therefore it is difficult to differentiate the kingdoms. A specific energy pattern could manifest itself in a member of any of the three kingdoms. Sensation is more specific for kingdoms. Each kingdom has its unique basic sensation. With the mineral kingdom the basic sensation is structure, and in the consciousness of each mineral substance this basic sensation of structure is expressed in a way quite unique to that substance.

With the animal kingdom the basic sensation is survival, and again in the consciousness of each animal this is experienced differently and in a way unique to itself. With the plant kingdom the basic sensation is sensitivity, and each plant family has it’s own peculiar kind of sensitivity. In case of diseased human beings the Vital Force is deranged so that man’s consciousness is altered. This altered consciousness is similar to a specific mineral/animal/plant consciousness from the Universe.

Homoeopathic remedies are prepared from plant/animal/mineral sources among others, and when these substances are potentized to a degree far beyond the material there remains in them nothing but the spirit or energy of the substance. These remedies, when administered in accordance with the Law of Similars, are capable of bringing back the altered state of man’s consciousness to a level where he is able to achieve the ‘higher purposes of his existence’; in this way health is restored.

In a diseased individual the altered state of consciousness is similar to the consciousness of a specific plant/animal/mineral substance (remedy source) from the universe. The diseased individual and the remedy source have in common the energy pattern and basic sensation. These, the energy pattern and basic sensation, are therefore non-human specific. This means that they are shared by human beings and some other substance(s) in the Universe. On the other hand, emotions and delusions could be human specific; they may be experienced only by human beings and may not be present in the consciousness of any other substance in the Universe.

Case Taking in a New Light:

The aim of case taking now is to reach to what is non-human specific in each patient. The patient will obviously begin with the name of his main physical complaint. From here one has to cut through the various levels and reach to the levels of sensation and energy.

While traversing the various levels one picks up (i) peculiar symptoms (sensations, modalities, concomitants, mental symptoms, delusions, dreams, cravings, aversions etc.) and (ii)sensations/words/expressions that have the potential to lead to the next level. At each level there are various sub-levels and to get from one level to the next one has to ask an appropriate question(s). Briefly the map of case taking is as follows:

Level 1
Question: So what exactly is happening?

Level 2: Fact

– What it is
– Fact qualified
– Peculiar
Question : How do you feel ? How does this affect you?

Level 3 Feeling
– What it is? (Common feelings, anger, fear, sadness.)
– Feeling qualified. (Feelings further described.)
– Feeling peculiar.(Peculiarity in the feeling.)

Question: How does it feel like? What comes to your mind? One situation that had a big effect on you ? How did that feel like?

Level 4 Delusion
– The situation
– How it is experienced?
– Dream

Question: What sensation do you experience in that situation ?
What are you showing by that gesture of your hand?

Level 5: Sensation
– Kingdom. (Sensitivity / structure / victim-aggressor.)
– Subkingdom / family.( Precise nature of the issue.)
– Source. (Precise degree, depth and quality.)

Level 6: Energy

Observation of energy patterns.

Quite obviously patients do not always give the case one level after the other. They may use other routes or they may get blocked or stuck at a particular level, and in such a case one would have to use a ‘by-pass.’ When a patient is unable to go beyond a particular level his level of experience is usually the previous level; this also determines the potency he needs. For example: if he cannot express feelings then he is stuck at the previous level of fact, and to get beyond the level of fact one would ask: what are the feelings he does not feel, what are the feelings he felt in the past etc.

The concept and the new method of case taking will be better understood from the following case:

This forty-eight year old man first consulted me on 19.11.’02. His main complaint was an orbital hemangioma for which he was advised surgery. He describes the problem during the interview. The consultation took place in my clinic in the midst of a clinical training course attended by fifteen homoeopaths from different parts of the world. The interview follows:

D: Describe your problem in as much detail as possible.
P: In the middle of September I observed a growth at the corner of my right eye. I was told it had something to do with a growth and I went for a CAT scan on the 18th of September. They said that it was a well-defined tumor, non malignant, so no hurry to have it done. Then I went and met the neurosurgeon who said that it is a rare thing and has five percent possibility of malignancy. (He talks about the problem without any apparent anxiety, seems quite calm, objective and matter-of-fact about the whole thing.)

My boss’s brother is a cardiac specialist, who suggested that I let it calm down, that I may have had this for some period of time already. But he went on to say that this is a time -bomb, that it may explode and suggested that I get it out completely. I’m a little confused hearing all these different assessments. The last fellow I saw said that he had done such hemangiomas before. ( Level I: name/diagnosis.)
My eyes are a little more red. No blurring of the vision and my eye movements are normal.
I’m diabetic, which was discovered ten years ago. Only when I had a myocardial infarction two years ago was I admitted to the hospital, and now I’m more regular in my treatment. I am trying to be more regular.
I have a stressful job, which requires me to travel at short notice. I enjoy it as well, working fourteen hours a day often. It’s an exciting job, where you see things happening. We do projects in other countries. The fact that my marriage is broken probably gives me a lot of time to invest in my work and business.
They say there’s no indication of my having had a myocardial infarction. I quit smoking for a year. Now I’m back to my usual lifestyle. I’m not unhappy about it.

D: Tell more about this eye problem?
P: I thought at first that it was a stye. I could feel it moving a little. In the morning it almost vanished into the orbit. I must say I was worried until many doctors said it was probably not malignant. So I think I’m comfortable and that took a lot of pressure off my mind, knowing it’s not likely to be malignant. It’s not caused me any discomfort unless I eat ice cream too quickly. I do self-checks several times a day to see how it is.
(Level II: fact But here there is no sensation with regard to the chief complaint, only redness. To go further one would ask about the effect of the problem on him
D: What do you feel about it now?
P: I feel it should come out. I think the redness also came out more because of drops I put in the eye. I had a major presentation and I put too many drops

D: So what effect does this have on you, this eye problem?
P: Quite honestly only that I know it’s there, but if I don’t do it it might encroach; it might encroach or encircle the optic nerve. So I’m scared. When I think of it logically it worries me. Other than heaviness of the eye. (Level III: emotion, viz. fear. There are two things to be noted here: 1.Even though there is fear he seems quite composed and matter-of-fact about it. 2. One has to understand this fear.)

D: Describe this fear a little more, of this encroaching?
P: I don’t want to contribute to my condition worsening by my becoming complacent. I also fear because my profession requires me to speak and interact and if my eyes are not coordinating.
I’m in a position of responsibility. I am a part of the executive. It requires a certain level of personal appearance, a certain need for confidence, which has to do with physical well-being and your appearance. I don’t want to lose that. (The fear is of losing the level of personal appearance, health and confidence required in his job. His job is one of responsibility and where he is required to speak and interact. The effect of the eye problem seems to be on his perceived role.)

D: Tell more about this level of personal appearance and confidence?
P: I have a need to look good, to be well dressed, to be well groomed. Whatever I had before I achieved this position had to be perfect and I took time making sure this was done. How you are perceived and how you look all has to do with your level of confidence. Appearances have to be in line with how you do in the corporate world.

If I was to be driving a taxi and the police rules said that you have to have a clean uniform then out of the need to be correct I would have the most clean, spotless uniform of every taxi driver in Bombay. Everything has to be perfectly polished, my shoes, socks etc. Everything has to be coordinated. (There is the need to be perfect and coordinated. He uses the word coordinated with regard to the eye problem as well as his work. This should be explored further.)

D: What do you mean by coordinated?
P: It must go with what I have. So I mean having everything in harmony that is adjusted to each other.

D: What is the opposite of that?
P: Turbulence, chaos. (It would have seemed that coordinated had to do with personal appearance. But when one asks him what the opposite is interestingly he says turbulence and chaos. Turbulence and chaos, coordinated and perfect, have to do with the cancer miasm. If it was specific to personal appearance he might have said something like not well groomed or unkempt.) The net effect is poor. Speaks of casualness, of not having an eye for detail, maybe not having any spirit.
To me it would be uncertainty, undefined, lack of purpose, no spirit, not having given enough thought, not having tried, cared, bothered, not having harmony, coordination, balance.

D: Give some example of lack of purpose, undefined?
P: When people don’t spend enough time; it could be with work. It could be picking up the first socks that come out. Similarly you don’t prepare yourself enough for the work you do, no need to excel. ‘Let’s see what happens’ kind of attitude. While I will allow things to happen, but without a due effort in anything I do. For a presentation before the chairman most people would want to spend five or six hours preparing, but I would want to think about it from his perspective.

So I would prepare for this meeting exceedingly thoroughly. What perspective does he need to see and then I will work on that relentlessly till I see what he needs and then I will spend time crafting it till there’s not much more than I can do. (The need for coordination and perfection is also there with regard to his work and presentations. If it is there in all areas in his life he will need Carcinosin. If it is confined to a specific area he will need another remedy of the cancer miasm.)

D: What’s the effect of that on you?
P: Stress, tension. It can also be excitement. One does these types of presentations six or ten times a year. It’s like performance. An artist cannot rehearse enough. Overly need to prepare, to go deeper in detail and see if from my points of view and it’s not superficial. Whatever I have to say has to be something that’s reliable, that’s coming from a level of authority and understanding.

D: Tell about the stress?
P: Not being well enough prepared, that I need to continue with my success from the past and most important that I do not fail. It is like a child taking the hands off the handle-bars and saying, “Look mom.” The pleasure of accomplishing and the attention he gets. (He needs to perform and accomplish in order to get attention. One has now to understand the quality and degree of this performance.)

Last year I went for a rock-climbing course. One of the things was to come rambling down the mountain and I have a fear of heights, a queasy feeling in the stomach. Though people made a lot of allowances for me the year before, that I’m not the youngest in the group, almost forty-eight. To me it was important to get some accomplishment over my own fear. I decided to do it and felt ten feet tall (Indicates the degree of performance.) at the end and I overcame my fear. So accomplishment came in accomplishing fear and all the negativity.

D: Tell a little bit about this fear of heights?
P: I don’t know if this is any more than anyone else’s fear. Standing at the top of a building I would like to instinctively go back. If I’m looking down and there’s a stone fence and I’m holding on there’s no fear. It’s not vertigo. I don’t have any fear of flying. I’ve flown in small aircraft, even putting my arms outside of the plane. If I’m at two hundred feet and there’s a pit below, I don’t think there’s too much fear.

D: Tell about this flying?
P: A friend had a plane. I quite enjoyed flying, liberty, vigor, being able to go in any direction, the combination of movements, so it was total freedom and you can move in a combination of movements at any time. Kind of fulfilled in a way like as a child and be able to look at the sky with birds, a feeling of freedom.

D: Tell about freedom? (Note the direction he is taking: effect of chief complaint->coordination and chaos->stress->fear of heights->flying->freedom. En route we noted cancer miasm, and the themes of performance and accomplishment. He seems successful and quite compensated. The aim is to understand him in as much depth as possible by picking up his own words, especially feelings, emotions, images and sensations, and asking him to describe these further till one comes to something deeper. The ultimate aim, as explained above, is to reach an experience, sensation or energy, which is non-human specific.)
P: Unhindered, unfettered, able to go in any direction as you like, when you like, where you like (The opposite has to be there, viz. bound with no place to move.) and yet with such a responsibility because if you’re not too mindful of what you’re doing the engine can actually stop and you can crash. So the freedom to move, but not irresponsibly. You have to be watchful of your action.

D: A slight contradiction?
P: Yes. When you’re flying it’s like no experience before. You can do this, do this; you can have combinations of movements and to be able to control this on your own, unlike driving is in itself a very exhilarating feeling and if you do this without responsibility you’re more likely to have a crash. Your aircraft may stall and you may not be able to control the stall. So freedom, but measured, not with abandon. Yes it is a contradiction, but…. (Freedom, but with control and responsibility. The freedom he further describes as exhilarating.)

D: So what is the exhilarating feeling?
P: Sense of adventure, sense of having accomplishing something. Not many people fly. It changes your life and allows you to think and do and be different, that’s what makes it exhilarating, that you’re not one of the many who came and went without being different.

D: When you say try to be different you mean…?
P: I would never do anything that’s foolhardy, but I would take some risks, worth taking so you can feel good with yourself, not anything disastrous. (So freedom and exhilaration have to do with performance and accomplishment. And performing not just something ordinary but something adventurous and different from the rest, something that is risky and requires control and responsibility. This is where he sees his role. Like the child with the hands off the bicycle handle, getting attention by performing different and risky things and getting attention.
Argentum has to do with performance in the new. Strontium is the line of new, the creative performance, and is afraid of trying out new things. Argentum nit. Has to do with performance in new situations and there is risk and danger involved. It is a remedy of the cancer miasm.)

D: What is disaster?
P: To go scuba diving and not be careful and get the bends. You know there’s a risk and if you do that in a foolhardy manner rather than going about it scientifically.

D: You talked a lot of freedom. What is your experience of freedom?
P: I’ll try to think how I can define it. Freedom is an ability to express your thoughts, your desires, in fact your actions, live your dreams if possible, without too much of inhibition and yet with responsibility. There has to be responsibility. When I was in college I experimented with drugs. I smoked grass. But I don’t think I’ve ever been in a situation where I would allow my need to try experiment get the better of me. Again, the same thing, disaster…I started drinking when I was in the army, but I’ve never, ever, ever drank more than two drinks in my life. I’ll go only to that point and not beyond; nothing would sway me. (Again the theme of trying out something new, something adventurous, risky, but within limits, keeping control.)

D: To that point?
P: Where I am in control of myself, but beyond that point I will stop.
In driving the moment I feel the car is not in my control or if I’ve not made allowances for someone else’s mistake then I’ve not…when I drive I drive with a full awareness of the car, the way the car is swaying, what is happening on the other side, with the bullock cart etc., but the moment I see that I am not in control of the car I apply the break. Flying is the same thing, a great responsibility, to be prepared for this thing, for that thing. As far as possible I would want to be on top of every situation. So there is that need for harmony, balance and control.

D: Tell about need for balance?
P: Control can be overly managed. What can be wrong. Work and go on. If I’m working on something with the car I will switch it off. So the consequences should be managed. There is a need to protect those around you from damage as much as possible, whether physical or psychological. One does give sometimes unsolicited advice. If I see a baby getting close to a plug I’ll not just ask to be careful. I’ll say, “Get away from there!” People may not say that to the child, but that’s the way I see it.
(We have gathered so far the need to perform and accomplish new, different and risky tasks in order to get attention, and the need for perfection, control and coordination. The performance is not something ordinary but of a very high degree. It involves a lot of responsibility, as with the high position he occupies in his job. The remedy is likely to be Argentumnit.
Having understood this we can now move to other areas in his life.
Another point to be noted here: Associated with the chief complaint was the fear that it might affect the level of confidence and personal appearance required by him in his job. As we went further the perception of his role, viz. performance in a new and risky situation while keeping full control and responsibility came out through his interests and hobbies, rather than directly from the chief complaint. The experience of the chief complaint is mostly as a fact with some emotions, expressed but not apparent. The level of experience of the chief complaint is Level II, and the potency required will be 30C repeatedly or LM potencies, especially 0/3.)

D: Where do you see control in your life?
P: There’s this girl I’m very much in love with, but I think what happened because of desire to control. When we first got married she couldn’t cook. She came from a home as an only child. She came with a lot of opulence. She wasn’t expected to cook or sew or run the house or learn any of these things. When I got married I discovered she really couldn’t cook. I learned to cook out of necessity and I was a reasonable cook. So my expression of love was to cook, to help out with the baby in the house, do all the little things. This created a sense of insecurity and probably of unhappiness in her. I didn’t realize that this might be seen as control or that that was control.
I was very happy to do this for her out of love. I started to play a more dominant role in the home situation instead of allowing her to grow. If she cooked something instead of just saying it was good I would say it was good but… That must have been distressing for her. It’s not that I would be prepared to tell a lie in such a situation. I’d tell her it was good, but then I’d tell her what was wrong with it.
So in the family situation the control started happening in that form. She relied on Dr. Spock and I felt that my instincts were quite good. To me it didn’t require much rocket science to see that the child needed to be burped. She did an outstanding job as a mother and still is outstanding as a mother. For me it would be very important to come back and say that don’t worry, it’s under control, that I’m managing it very well. It’s just another form of wanting to be in control or is it that I just don’t want people to be hurt. (Again there is the desire to control, for things to be done perfectly.)

D: And then what happened? Why did you split up?
P: We split up on a matter of principle and I was very rigid on some matters. My mother in law didn’t have the money to pay off the tenants and I had the money. She wanted me to pay now and later she’d be good for it. I found out later that she’d sold her shop and didn’t pay me. I don’t think she wanted to cheat me, but she wanted to control me. Having controlled one child all her life here was another child she wanted to control. (Here the feeling is that he was being controlled.) What spoiled our relationship was that she took her mother’s side. I felt that if she needed the money she should have said she needed it and not done it behind my back. She said that I had a vested interest in it and then I was shattered. (This is an expression he has used for the first time. In this expression lies his feeling/delusion/sensation with regard to the incident.)

D: Tell about shattered?
P: Sense of let down, stabbed in the back from someone you would never expect. Deep disappointment, being let down, being betrayed. (These are emotions, which may be human specific, and should be explored further and reduced to something non-human specific.)

D: What’s the feeling then?
P: Hurt, like physical hurt.

D: Describe that physical hurt?
P: Almost like being boxed very hard in the stomach.

D: How does it feel? What is the sensation?
P: You lose your breath. You feel like you will die…choked.

D: Describe that choked?
P: You can’t breathe. Someone has taken your life away.

D: Describe just that sensation of losing you breath, die, can’t breathe a little more?
P: It’s like drowning.

D: You are doing well. Tell more about this.
P: Like wanting to gasp for air, to come out of this situation, but not being sure if you can or you will.

D: More?
P: Wanting to escape from the situation, run away.

D: Where have you actually felt this gasping for air, wanting to come out ? In which situation have you actually felt it?
P: Actually only while swimming. Maybe due to a faulty technique. Some breathe very well; some don’t. So even though I can swim, practically the whole length of the pool under water, but when it comes onto doing the crawl I would tend to hold my breath the way I do under water and the last eight or ten feet I would feel a desperate need to hold on and wanting to get to the other side quickly. Whereas when I’m under water there’s no need to rush, I am calm. But when on the surface that’s how I feel. It happens till this day.

D: What is this feeling?
P: It is just till I get to the other side.

D: Some other incident or experience with this desperation to come out?
P: While doing the MRI. I don’t know if I’m claustrophobic and then to have only two or three inches of space from your nose… I have no way to describe it. I could calm myself with prayer. The first moments were like being in a coffin. I decided to shut my eyes and pray. Then they said that I would have to do the test again because it didn’t come out right. It was like a second death, but surprisingly I didn’t feel too uncomfortable about it.
(This is very interesting. He begins with shattered, which comes close to crash. But it is something we have not heard as yet, and so we explore it further. From shattered he goes to stabbed in the back and betrayed. From there to boxed in the stomach which would make one think of injury, and so can be confusing. But when asked about boxed in the stomach he talks about losing his breath, gasping for air and wanting to escape from that situation, feeling claustrophobic. This is the opposite of his description of freedom where you are unhindered, unfettered and can move any way you want.)

D: What was the feeling the first time?
P: Wanting to get out desperately and being held and bound.

D: What is opposite of bound?
P: Feeling of being able to move any way you want as I described with flying.

D: When unable to move and bound and held, what is the feeling?
P: Desperation.

D: Describe that feeling?
P: It’s deep anguish because you want to change the situation and you can’t. It’s extreme restlessness because you don’t want to be held where you are and you are being held there. Totally out of control on how you would want the situation to be. Total lack of capability to be able to influence your situation or environment in any way. (Being held and bound is being completely out of control and that makes him desperate. Desperate in a situation where he is out of control or has no influence on the situation. This feeling is very typically cancer miasm. And he copes by remaining in control, wanting to be in control. This sensation of suffocation equates in his mind with crashing and falling. And this is related to the mineral kingdom.)

D: So how does that feel?
P: Feels like you ought to be dead.

D: Where is it felt at that time, legs, feet etc. etc.?
P: I certainly break into a sweat and I’m sure my pulse and blood pressure shoots up. I’m not sure, but I’m acutely stressed. I think my breathing certainly is shallower, trying to gulp as much air as you can and as fast as you can.

D: Claustrophobia, any other experiences?
P: Once before. Hiding under the bed of my girl friend…terror filled me. Her uncle came home, not that I did anything hanky panky. She was paranoid that I didn’t want to be seen, so she put me under her bed and there again it was very close to me. I sneezed very loud and I was discovered. He wasn’t so bad. He actually asked me to join him for a glass of beer.

D: What did you feel?
P: My mind was not on being discovered, but on being claustrophobic.

D: Can you tell more about this feeling of being shattered you spoke of earlier?
P: That’s the point where I felt that I need to move away from this relationship. I wanted to get as much space and time for both sides to reconcile. (Again the need for space, the opposite of held and bound, claustrophobia. So he got out of the situation.) I’ll let you realize that you made a mistake and I’ll not make you feel small for realizing that.

D: You used the word adventure…tell a little bit about that.
P: Like trying scuba diving, or try some flying. That’s one form of adventure. Adventure is also going to an unknown setting where you have no friends and if anything happens to you…I’m in Jakarta or Sao Paolo etc. where you have no back ups, not safety nets and it’s also when you’ve finished your dinner and you go out and you know there’s danger on the streets. But again I would do it with a sense of responsibility. So I will walk on the sides where the shops are. It gives also a sense of adventure.
(Risk, danger, adventure, but with responsibility.)

D: Why do you walk then?
P: You can’t sit in your room and watch TV, which I never do well at home. There has to be some sense of exploration and going out.
There’s a sense of adventure in business, to try out new countries, to see if you can enter those markets, try out your models to see if they’re viable, look at them as potential business partners.

D: What is that feeling?
P: Accomplishment, well not that, but you tried it. A lot of pursuing and perseverance, just happy for actually having tried it, for having gone beyond the obvious. I enjoy it.
(The same feelings and themes keep coming up. So now we go to the dreams.)

D: Tell some dreams you get.
P: One dream I used to get a lot of the time is actually floating in the air. Going from point A to point B like I would swim, fantastic. Feeling of being totally mobile, freedom again, being unhindered, unfettered. Similar to that is also swimming so I feel those two are linked in a way. (Heights and freedom are the themes here. One should also expect falling.)

D: Anything to do with falling?
P: There are times when I have dreamt of falling from an elevation. Just a free fall like you would do out of a plane, no parachute. Unpleasant, floating in the air.
Attached, eroticism, sexually romantic rather than be very lustful.
Missing trains, flights, being unprepared, all business related dreams. Not that anyone has anything bad about me, but I had goals and fell short.

D: Tell about missing planes or buses?
P: I don’t think I’ve ever missed, but I remember a few times in childhood where someone was seeing someone off and there was a lot of crying and unhappiness. I’d see my mom crying or my grandmother crying and as a three or four year old you couldn’t understand why everyone was in tears.

D: What is the dream like?
P: Just somebody in a train that is leaving and I almost go there and the last shot was he almost gets there and he doesn’t. Feeling of sadness, didn’t have to be so. The need to struggle, to strive and hopefully something will happen at the last gasp. Getting in control and things will ultimately be right if the effort is made. (The train is going away and you really have to struggle to reach it. You give it your best and then there is some hope or chance that you could get there. This is typically cancer miasm and also Argentum nitricum.)
I must also mention that I sleep very late sometimes. Great activity can happen so that sleep doesn’t happen till 1. Dramas happening and all kinds of possibilities, so it’s a mixed bag. I think I’ve been self indulgent as far as sleep is concerned.

D: Tell something about your likes and dislikes in food and drink.
P: I don’t like fish at all. I don’t like the smell of it. I like sweets. Tell about sweets. I enjoy sweets, ones that are milk based more than anything else.

D: Ice cream? (He has mentioned it earlier, and it is a well-known craving of Argentum nit.)
P: I like ice cream.

D: Little or very fond of?
P: I like it and if I had two tubs I would gladly finish them.

D: What are the situations you used to get very tense or nervous? (One would be looking for anxiety related to examinations, interviews and public speaking as a further confirmation.)
P: With my father. Very nice man, very family oriented, but I would never be quite sure as to what his reaction would be. There were times he’d laugh anything off with boys will be boys. And there were times he’d be severely critical and reprimand and maybe use his hand, for things I thought were no big deal. So I was in confusion as to whether I’d meet his approval or not for things I’d done. Acceptance or rejection by my father and all that can do to a child when you feel you can’t live up to his expectation. (Carcinosin children usually feel a high expectation from their parents.)
Tense in medical situations when someone in the family has to be in the hospital. I’d very tense. I was tense when my wife was in the hospital for seventeen days, but I must say I wasn’t in abject fear. I would discuss with absolute rationality what to do and what are the chances, risks etc. (Again he is controlled in a tense situation.) There’s a tension to get through.

D: What is the feeling in the tension?
P: There’s a mix of needing to do and know what to do. Opposite is despair, that maybe the worst can happen. When the views are widely divergent it leads to confusion.

D: How do you experience it in that situation?
P: I feel it’s no big deal, that it can be handled easily.

D: How do you feel? What’s your emotion?
P: A little short of disgust for the doctors: “Come on guys; you should know this!” I expected you’re the guys who should have figured it out. Maybe disappointment. (He has very high expectations of the doctors and when they do not fulfill it he feels disgusted. One can imagine that he would feel disgusted about himself when he is unable to meet high expectations, for example those from his father.) Like a child I would want these two boys to sit down and in awe watch them figure it out.

D: How do you feel emotionally?
P: I feel confused and unhappy. (In the beginning of the interview also he spoke of confusion when the doctors all suggested different approaches.)

D: Describe the feeling of confusion?
P: Uncertainty. Feel lost. Like being lost in a fair ground, absolute fear, fear of having been abandoned, not knowing what’s going to happen. For a child being lost there’s nothing else. (Lost and abandoned: similar to Delusion, deserted he is, which is a symptom of Argentumnit.)
D: What does a child feel like?
P: The feeling is a sense of abandonment. It’s traumatic; it’s scary. I think fear is the most predominant feeling.

D: How does the fear feel? You can use pictures or examples to describe the fear.
P: If the child was able to become seven feet tall (Again the theme of being very tall.) and stand above the people around him, his head would go round and round looking to see where they’ve gone. The fact that the child is so low in height, if I were a child I’d like to be seven feet tall and have my head go round and round. Then you find the parents. (The child is very small and unable to find his parents. If he could become really very, very tall then he might succeed. Again, this gives the depth of the cancer miasm.)

D: What do you feel?
P: Relief, overpowering relief…that everything will be right for my world. The child has a small world, parents and grandparents. Since the parents are the central figure then everything will be alright with your world.

D: And when the parents are lost?
P: The world has crumbled. (Similar to shattered, which was the feeling he expressed with regard to his marriage.)

D: How does it feel when the world has crumbled?
P: You feel like sobbing. You feel inconsolable.

D: Where have you felt this, this feeling of crumbled and inconsolable?
P: I think when my mom died. That’s the biggest sense of loss that I’ve suffered when she died. She and I never had a very good relationship, always felt she loved my sister more. So when she was dying the last three or four weeks there was a huge sense of disappointment, how a life time has gone by without a sense of expression. My mother didn’t express love with physical contact. Her expression was doing things quietly, putting things away. It was one hundred percent love. I took it for granted. To me it was holding, hugging and kissing and that I missed. She was dying of cancer. (Family history of cancer.) There was such little time and there was no hoping she would survive. The night before she died I prayed to God to let her go, while she had the dignity in tact, so we had something to cherish. (He never got the love from his mother in the way that he had wanted it. She had very little time left and he was trying desperately to make up for it in the last few days.)

D: Interests and hobbies as a young man?
P: Collecting stamps etc. Nothing that stayed.

D: Anything particularly you were talented at?
P: I do painting, water colors. I wouldn’t say I’m good, reasonably good. I write. I also find myself fairly good with languages. I know I speak good English, but I still think in Hindi. If I had nothing to do and had all the money in the world I’d probably travel and learn languages.

D: You talked about stage appearances?
P: In school, plays and elocution. Distraction and I’d lose interest in something as soon as I developed a proficiency in something.

D: What is your work now mainly?
P: To set up projects now for this company in many parts of the world. I have to find the right talent and train them because I can’t manage a multi locational program.

D: What is the stress of these programs?
P: Getting your board of directors to agree with your project and allow them to think as you would, that it’s a desirable project.

D: How do you feel in that situation?
P: I think I’m restless. If I’ve thought through this right, as thoroughly as I have then you have no choice Mr. Board of Directors. There’s an anxiety beforehand if that situation will be accepted. Anxiety from over preparation and going through this once or twice. It’s like a surgeon, giving this a once over. I would have loss of appetite, loss of sleep. I’d be quizzing myself, never ending and the kind I don’t think the chairman would ever think of it. It’s almost like being given an examination, but being given by me to myself.

D: How were you in examinations?
P: Very good. All the anxiety would make you think I’m scared of examinations, but I’m not scared.

D: Before examinations in school and college?
P: I would be tense, but not tense like I am now.

D: Any physical problems?
P: Yeah, maybe a need to go to the toilet.

D: So generally you’ve been fairly successful?
P: Yes successful. I’ve done a fairly good job and have seen that from my colleagues.

D: How are you with animals?
P: I’m good with animals. I’m not patient with people, but infinitely patient with children and animals.

D: With plants?
P: I like plants and greenery. If all of us plant just one tree, just one tree in a year, then our whole country would be green. So greening the country side…

D: About keeping things in order?
P: To me it’s important to have whatever you do done well. It’s an instinctual desire.

D: What do you expect from homeopathy?
P: First and foremost that this thing doesn’t grow anymore and if it can will reduce in size. If it can be shortened and made to grow away, outstanding. ( It should be brought under control, in the first place; and if there is that small chance of it being completely eradicated it will be perfect for him.) After this, to improve my quality of life and I will work very hard at this. If it can help me manage my sugar and my quality of health.

Further comments:

Incidentally, Arg-nit. is also one of twenty-six remedies mentioned for hemangioma.

The main theme of Argentum nitricum is performance in sudden danger or crisis. The feeling of the person is that he will be accepted only if he can perform in the time of a crisis; otherwise he stands despised and deserted.

In this case there was the compulsion to be perfect and to perform and accomplish, and his chief complaint could affect these. The performance and perfection were often required in situations which had to do with something new, and something dangerous, and in order to maintain his performance in these situations he needed to be in full control. That would give him the acknowledgment that he needed so he wouldn’t feel abandoned. As the reader will note all of this emerged in his case by just holding on to the chief complaint and going step by step from there.

His pathology is progressing gradually, but going higher and higher. His disturbance therefore is similar to the gradually ascending LM potencies. As explained above I started with LM 3.

The emotional symptoms are absolutely untrue. This is a very important lesson to be learned from this case. The word itself is misguiding often; it is the experience of it that is individual and relevant. When he describes being stabbed in the back as a box in the stomach it still isn’t deep enough. Nowhere else in the case did he say boxed. But when asked about the experience of it he says it is like gasping for air and the opposite of that for him is freedom. The fact, feeling, delusion/image are not enough; what the patient says has to be reduced to a sensation, to an experience. This is the true symptom.
REMEDY PRESCRIBED:

Argentum nitricum 0/3 on 20.11.2001.
FOLLOW-UP:
10-01-2002:

Feeling better
Swelling better.
Vision better.
Sleep good. Pleasant dreams, nice, good, interaction with people, thing are happening. Situations which would have been tense are quite pleasant. Good feeling, no tension. Enjoy the dream.

REMEDY: Argentum nitricum 0/4/1
26-03-2003.
Major reduction in size of swelling. MRI shows reduction in size by ninety percent.
The swelling is now just a small tissue onion-skin thin. ( Initial size: 3 ½ x 2 x1cm. Presently: 1x1cm. No thickness.)
Started getting better within four weeks. Pressure reduced, pain reduced, feeling well.
High energy level.
Reconciled with ex-wife, relationship improved.
Sleep better. Get up alert.
Pace and speed are the same.
Major presentations, proposals.
Lot in control.
Blood Sugar: 161/179 in Oct.2001. On hypoglycaemic agents.

REMEDY: Argentum nitricum 0/4.
8-8-02:
Have cut hypoglycaemic agents down to half the dosage.
Feel a lot better.
Had been experiencing a burning sensation in the feet which is less.
Friendly with wife.
Planning a holiday. Anxiety and stress levels have reduced. What would make me very angry earlier no longer affects with the same intensity.
Anxiety before presentation is less. Still need to prepare till the last detail but it is much easier now. Earlier because I was hyper everyone around me would be hyper, and that would build up pressure.

REMEDY: Argentum nit. 0/6

17-09 -02:
(Comes very casually dressed.)
Been good.
Personal life, professional life.
Professionally things are good.
Personally spending lot of time together with wife.
Anxiety is much better.
Calmed down.
Things which manifested anger, don`t even realize that now. hort-tempered nature is much better. Calmer, earlier great need to be a perfectionist, otherwise blow up.Never had the patience. Now being more patient. In greater control of feelings, temper. It is not necessary that things have to be perfect.
After three years have taken leave. Otherwise would have been very guilty, anxious. Now am sitting at home, relaxed.

D: What difference has that made to you? (This is a question I usually put to the patients in follow ups. There is a pattern or a sensation or a delusion that is the disease. While it is there it affects and limits the patient. It’s disappearance/dilution should mean a step towards restoration of health and freedom.)
P: Calmer, peace. No anxiety. Don`t need to worry too much. Things are just happening.
Overall good feeling.
The burning of feet like stabs of pain below knee has diminished.
Frequency of pains is less.

REMEDY: Continue Argentum nit.0/6

2-11-02
Workload is more but taking it easier. There is not that much need to keep things in control or achieve.
REMEDY: Continue Argentum nit.0/6
The concept of the levels and this new approach to case taking have so far yielded for me and some of my colleagues, very encouraging results. We are able now to prescribe remedies we might never have otherwise used. But I would like to add that these ideas are continue to evolve and techniques continue to get more and more refined. It is a work in progress. As with An Insight Into Plants, I feel there are sufficient results to convince me that there is at least some truth in the idea and it has much potential. So long as we have failures, we need to look deeper, to look wider and to continue to evolve in our concepts and techniques. In this way we can hope for better and more definite results in our cherished and chosen task of restoring the sick to health.

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About the author

Rajan Sankaran

Rajan Sankaran

Rajan Sankaran, MD (Hom), FSHom (UK) is reputed to be a clear and original thinker and is best known for his path breaking concepts in Homoeopathy. His understanding of ‘disease as a delusion’ followed by his discovery of newer miasms, classification of diseased states into kingdoms and the seven levels of experience, brought in much more clarity into understanding diseased states. The Sensation method has now evolved into a more comprehensive and synergistic approach, which strongly advocates to encompass and integrate the old, classical and traditional approaches with the latest advances.

Dr. Sankaran heads ‘the other song—International Academy of Advanced Homoeopathy’, in Mumbai. This academy primarily focuses on imparting advanced clinical training to students and practitioners, integrated with a homoeopathic healing centre. Also he has his own personal clinic at Juhu area of Mumbai, India. He is also the President of Synergy Homeopathic, which is dedicated to the development of reliable, comprehensive homeopathic software and teaching tools. www.theothersong.com www.sankaransclinic.com www.synergyhomeopathic.com

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