Clinical Cases

THEMES: A Parameter for Following a Case

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SUMMARY:

Based upon Dr. Masi Elizalde’s concepts, the author describes how to make a homeopathic prescription by comparing the theme of the patient with that of the remedy. This study was introduced by Dr. Masi Elizalde as one of the first steps in the study of Materia Medica. The goal was to understand the individual aspects of the medicine and patient. The prescription is based on themes and it’s correctness indicated by the patient’s course and the remission of symptoms.

INTRODUCTION
There are various ways to make a homeopathic prescription. Comparing the patient’s themes with themes of homeopathic medicines, is one way.

We have to find the patient theme which is similar to the medicine’s theme. To follow a case this way, we have to analyze whether the patient’s themes have changed. After the prescription, the themes have to be the same, (the changes we observe are in the intensity) but the symptoms must change. It’s basically still the same person. In this case we can see the various prescriptions and the clinical changes that occur.

METHODOLOGY:

The patient has been studied in terms of themes. We could see that those themes were the same as those of Silícea, so this medicine was prescribed. The case was followed according to parameters proposed by Dr. Masi Elizalde. After the prescription, on each consultation, we saw how the clinical picture improved and how the mental symptoms had changed, confirming that a cure was in progress. We could observe how the individual was changing in the direction of cure. The lesions he presented with have disappeared completely.

THEMES

Before presenting the patient’s themes, let us define what a theme is. A theme is a group of symptoms that expresses the same idea, the same content and the same subject. The frequency of a symptom can make it a theme. A key-note symptom can also become a theme. A strange word that appears in Materia Médica can be a theme also, if the patient repeats it frequently. The themes, after the prescription, have to be the same, but they now have a different meaning, without the suffering which was presented before.
THE CASE 12/95
“DIRTINESS / CLEANLINESS”

I felt dirty, filthy, promiscuous, contaminated. I like to keep things clean. I’m very keen on keeping everything clean.
I have a thing with cleanliness, more often towards my body. I’m afraid to be contaminated, of getting sick.
I don’t eat in some places, if I don’t think they are clean.
BODY

The monomania for cleanliness is just towards the body. Frequently taking showers, wearing perfume, fear of contamination.
“I have some difficulty with body odors, I take many showers”.
TIMIDITY

I am embarrassed and timid.
Timidity dominates me because of anything new.
The timidity is related to the public, towards sexuality.

DISEASE

Fear of contamination.
Fear of getting a disease, of having a disease.
Fear of dying.
I become crazy with the results of exams.
I become very anxious, tense, I feel somewhat bad inside.
I lose control when I have to do some exams.
I become tense, anguished. I don’t know why. Internally I was tense.
Going to the doctor always causes me some fear.
THE NEW

I have some difficulties with new things, with new situations. The new.
The timidity dominates me on that.
SUSPICIOUS

I become a little suspicious with things. Specially at work.
THE JUDGEMENT

I become worried with my sexuality in relation to others. It is bad to be judged by just one aspect.
Fear of someone finding me stupid.
It is my difficulty to feel human, to fail, to make mistakes.

DISRESPECT

I quit a job when some students disrespected me.
THE TEST

Fear of tests. A test is a window.
COLD/FREEZING

My hands become cold. It has always been like that. Before the analysis it used to be worse. Always with my hands cold, freezing.

FAILURE

Fear of taking tests. I have always felt that terror.
A test is like a window.
I become anxious when I come to the doctor. The doctor will notice my faults.
I felt that way when I was going to teach classes, when I was going to make an examination, to make sex.
Fear of failure, not to have a good performance.
To face my own limits.
To see my faults.
It is easier to see my faults than to see my qualities.
It is difficult to feel human, to fail, to make mistakes.
It is hard for me to make mistakes. I accept it but I dislike it.
SELF-DEMAND

I’m very demanding towards myself. Too much.
I’m very self-critical.
I have to do a very good thing, an excellent one.
I try to make it more sophisticated, and it doesn’t come out very well.
I’m excessively turned to aesthetics.
I keep searching for the right words.
It is hard for me to make mistakes. I really dislike it.
I had several cases of flu, I got a swelling on my penis, all that in a time of a lot of self-demand.
To take care of my wife. I had no conditions for that.
The self-demand is a need of a greater perfection.
REJECTION

The doctor will know what I am like and will reject me.
I have a history of rejection in my family.
I do a lot of things for my wife so that she feels happy, and this is a symptom of that.
IMPRESSIONABILITY

I am afraid of corpses, spirits from beyond.

KNOWLEDGE

I become extremely curious when there is something to know about.

IT’S ALL MY FAULT

I feel guilty for my wife’s womb cancer, it seems it’s my fault because of the virus.
Whatever happens I think it’s my fault. I keep a big feeling of fault about everything.
If someone hits my car, I get out of it thinking it’s my fault. I feel guilty in this situation. It’s a general feeling of fault, it’s not sectioned.

THE REMEDY SILÍCEA

THEMES
WRONG

Most excessive scruples of conscience about trifles, as though he had done a great wrong.
Whimsical and fault-finding.
He gets confused and makes mistakes, half knowing what he is about, and yet unable to control himself; he had almost put a watch into the saucepan to boil instead of an egg.
Easily makes mistakes in talking.

REJECTION

MIND-FORSAKEN FEELING, beloved by his parents, wife, friends, feels of not being
COLD

EXTREMITIES, COLD, hands
GENERAL, COLD, agg

We can see that the patient tells us the same thing through his themes: When he says that he searches for correct words; that he is afraid of doctors because the doctor will see his faults; that he is afraid of rejection and has a fear of failing, he is saying just one thing: wrong/fail. This is the principal theme of Silícea.

TIMIDITY
DISEASE
THE NEW
THE JUDGEMENT
THE TEST
FAILURE
SELF-DEMAND
REJECTION
KNOWLEDGE
IT’S ALL MY FAULT

After the prescription, we will see how the patient appears regarding these aspects of his nature. The changes we observe will be in the themes which express the central theme. They will show how the patient will act in situations where the central theme is represented. This will indicate how the disease has ameliorated, i.e., the individual is on the road to cure.

AFTER THE PRESCRIPTION

02/96 – 60 DAYS AFTER SILÍCEA 1MFC

At this consultation the patient had 100% amelioration of the hemorrhoids.

Feels itching on his penis, some sort of pricking.

NEW THEME:

OBSTACLE:

in face of some obstacles i don’t feel the firmness that i should.
A test is an obstacle, a difficult situation, a competition, a final term-paper for a course, or having to give classes.
Firmness means to me, when I am able to face a situation well, stopping to think and then I can go ahead.
Fear drives me to give things up.
Sometimes in the middle of a test I feel like giving up.

NO PRESCRIPTION HAS BEEN MADE.

We decided to wait because the patient had presented amelioration of hemorrhoids, confirming the medicine prescribed with this new theme.
60 DAYS AFTER THE LAST CONSULTATION
04/96

Some blisters had appeared on my hands and they were disappearing. The skin became thicker and was desquamating. It doesn’t itch or burn. It just became thicker and desquamating.
About my hemorroidheas, I am better than the last time.
The stool is normal, every day and not so hard as before.
I feel more relaxed in relation to others. I had much reservation in relation to others, I was afraid to approach them, I thought they could reject me.
I am not so apprehensive if I go to the doctor, it doesn’t worry me any more.

THEMES: TIMIDITY / DISEASE/ REJECTION

No prescription has been made. The patient presented a good clinical amelioration, together with the changes of the themes of “disease” and “rejection”, which can be appreciated on this consultation : Two months later 06/96

My hands continue desquamating. My self-esteem is very good. I feel good, I like myself. I really don’t like when I make any mistake. I can see that I am not secure, that I can make mistakes and I dislike it. I am not so anxious as I was before.

In this consultation, the patient presented a superficialization on hands, desquamating, with little pimples, no itching, no burning. He feels well, his self-esteem is better, but the sensitivity to mistakes persists and this is his individualization. He will always be sensitive to this, but not as he used to be.


TWO MONTHS LATER

08/96

I haven’t had the test made yet because I’m afraid of it, that’s complicated for me. I’ve always thought I’m not highly regarded, so I get annoyed, upset.

THREE MONTHS LATER
11/96

I don’t feel anything about the hemorrhoid. I feel more tense, anguished. I always feel like that when facing a problem, or when there is a test, a lecture to do. When I face a problem I become vulnerable. This anguish causes some pressure on my neck.

SILÍCEA 10 MFC
We decided to prescribe a new dose because the patient became anguished, tense on the same points he was before. We can see that every time he needs a new potency of the medicine, he will show the symptoms of the same central theme.

THREE MONTHS LATER
02/97

Small blisters on my whole body, they don’t itch, and they appear more where there is perspiration. The lesions are diminishing but they burn when using soap.

I think I got a lot better. I had to write a great part of my thesis again but I didn’t worry about it. He told me that it was necessary to change it and I did it. I become worried with it.

THREE MONTHS LATER
05/97

I am not so scared with diseases as I was before. I have been feeling much better. The hemorroids didn’t incapacitate any more. I feel some itching on my penis and on my scrotum.
I feel much better, relaxed, I have been making my thesis, without any trouble. I have been sleeping very well. Sleeping all night.
AFTER SILICEA 50 MFC THE EXAMS SHOW.

TWO MONTHS LATER
07/97

The last exam I made showed just one lesion on the scrotum. I am very well. I am developing my thesis very well, I am having a very good performance. I don’t like to be angry but with my mother-in-law it is impossible. Everything is wrong to her. She comes to my home and sees faults in everything and I can’t accept it. It’s my house not hers.
I am sleeping well, all night, without nightmares.
Stool goes very well, without any pain, or anything else.
THREE MONTHS LATER
10/97

I am very anxious with my thesis, I am writing it. I have a very strong pain in my back. I have it sometimes, it’s because I am tense for the end of my thesis. I’ve had this pain since 1986, and sometimes it aches hard. It always appears when I am tense. “Yesterday I lighted a match and put it under the sink and I put a dishcloth in the fridge”

He gets confused and makes mistakes, half knowing what he is about, and yet unable to control himself; he had almost put a watch into the saucepan to boil instead of an egg).

With my thesis I feel an internal self-demand, a fear and sometimes I wish not to make it. (again the theme of obstacles appears hard).
I have fear, I think that I won’t make it. I think it is because of my scruples. To think that I’m working, but I’m not benefiting from it. My anxiety is because I want to write and I think I won’t make it in the end. It is easier, I think that I won’t have enough time but I finish it. This last time, I put many books on the table, I used half notebook but I didn’t fancy the color of the notebook and I didn’t go well.

SILÍCEA 50MFC

We had prescribed a new potency because the patient was suffering in the same areas we found at the beginning. A new dose of the same medicine is indicated. The themes of wrong, fail and self-demand are again dominating him, and his thoughts make him anxious and tense (with pain in his back).

THREE MONTHS LATER
01/98
My fear has diminished a lot. It still exists but not as it was before. My counselor finds me eager, jumpy, he feels annoyed with me. I send him material for reading, and after one week I call him for an answer. I wrote two chapters of my thesis without any problem. I feel better, much better, without anxiety as before.
TWO MONTHS LATER
03/98

I have very good news for us. At the last exam no lesions can be seen by the doctor who made the exam. There is no photo because there is no lesion. I am very well, writing my thesis, I traveled to Europe on vacation and now I will have to come back to my work. My hemorrhoids don’t disturb me and I feel calm, relaxed. Anguish seldom appears. I don’t worry with failures and mistakes as I did before. I feel more self-confident in my acts. That’s how I’ve felt day by day.

THE LAST EXAMS MADE ON MARCH / 98

CONCLUSION:

It’s important to follow the themes in a case. Through them we can see the mental changes that occur during the remedy’s action. With the clinical amelioration we can observe how the individual can modify after the prescription. We can construct themes with the patient´s words and observe these from his statements during treatment. We can see that all the themes tell us the same thing, which is the big theme. It tells us the individuality of the patient and has to be followed as a parameter in assessing cure.
This patient is still using Silicia and he did not present those symptoms any more. He is still more confident and I could see that 50MFC is the best potency for him.

About the author

Conrado Mariano Tarcitano Filho

Dr. Conrado Mariano Tarcitano Filho
Instituto de homeopatia James Tyler Kent
Escola Kentiana do Rio de Janeiro

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