28th Dec 2019 – A 29-year-old male patient presented with Urticaria. He said he’s had this allergy for -he last 3-4 months. It started from the inner thighs and then spread to the back and progressed in an upward direction. He mentioned that it comes on every 3rd day.
He complained of itching and burning. He said, ‘I take Avil (anti-histaminic) tablet and I feel better within 5 minutes.’ If tablet is not taken, then it takes 3-4 hours for the itching to subside.
He likes spicy and fried foods but doesn’t like sweets at all. He likes cold water, but that aggravates. He has perspiration on his face, especially on the forehead and also on the soles of his feet.
He mentioned a very peculiar dream. He is driving a car and suddenly the brakes fail. The car takes left and right turns, he feels ghabrahat (anxiety) and wakes up. In the experience of ghabrahat he says, ‘I try to wake up, but I am unable to do so. There is some weight on his chest, like a pressure. “I am trying to call them for help, but meri awaaz hi nahi nikal rahi hai (I am unable to scream, my voice is not coming out).
In a second dream: ‘Some animal is behind me, I am running in the forest out of fear, shouting for help, I fall in the well, there is noise of water splashing and I wake up.’
Other dreams include snakes trying to bite him and he feels he will die. He has a fear of high places from which he fears falling.
When asked about his nature, he said he is a very quiet person and doesn’t talk much. Doesn’t mix easily with people. He takes time in making friends. ‘I get angry if someone blames me, even if I have not made a mistake.
He doesn’t like crowded places, noise, going out, movies. He prefers to stay at home. He doesn’t trust people very easily. He mentions one incident.
“One of my colleagues in the office had some financial issues and he requested me to give him some money. I gave him Rs. 2000 and he left Mumbai. He did not return my money. Of a similar incident he stated: ‘I gave Rs. 5000 to one more friend, he went to his native place, Even he did not return my money. “
This was the case in its entirety. After collecting all of the above data, we now come to the most important part, that is, how we analyze and synthesize all of the symptoms that we have collected into its component parts. We will do this in such a way that they will all connect through one single remedy strand that connects all of the dots!
We can take the first important symptom that we are sure of. This symptom is called the anchor, which will ground us and stop us from floating in the haze of many symptoms.
In this case, the anchoring symptom as rubric is:
This rubric gives us a short list of remedies and now we have to check each remedy individually to see if it fits our patient. In many cases, one of them may fit but if it does not fit, then we have to keep going forward and not stop at this rubric.
Now, we can analyze the case further by taking the Sectorial Totality of each area in the patient’s life. When a patient comes with many symptoms, we should not get lost in the maze. If we take a proper sectorial totality and repertorise the symptoms in a structured way, we will not get lost.
First we repertorise the dreams, as that’s the most peculiar aspect here:
then the fears:
then his nature:
and then the chief complaint, skin:
Structured repertorisation is a tool that Dr. Sankaran uses where he takes different totalities of symptoms in different areas of an individual’s life, then combines all of the smaller totalities to come to the same remedy.
In some cases where different aspects of the patient, such as the chief complaint, the concomitants, the mental state, etcetera can be elicited in detail, we can make totalities of these different areas of the individual’s life.
The different totalities thus formed, also lead us to the same remedy. This helps in the confirmation of the remedy. Along with this, to help us confirm the remedy is the System and the Materia Medica.
Then we can take the entire totality of symptoms together:
Now, considering we have the same remedies coming up in sectorial totalities, we have to confirm from the Materia Medica. The repertory is just a tool and should not be used without the materia medica to support it.
We see that Dr. Phatak has mentioned Silica as having itching during evening in his materia medica. This helps us in confirming our remedy and to be more sure of our prescription.
After going through the totality of symptoms with the help of repertory, we see that Silica covers all the areas in the case viz. mind state of the patient, his dreams, his physical generals and physical particulars.
Also, Silica covers the peculiar modality in the case – itching worse during evening. So, based on the above, Silica was selected for the case. As the symptoms of the remedy matched the symptoms of the patient at the level of dreams, 1M potency was selected.
Silica 1M one dose once a month was prescribed to the patient.
Remedy prescribed on 28th December 2019: Silica 1M one dose.
Follow Up after 3 months:
Patient says, ‘Urticaria is gone.’ Generally, he is doing very good. Sleep is refreshing. There are no dreams. Appetite and thirst are good. Mental state is also normal and calm. Asked about any stress or anxiety, he said he doesn’t have any. Over all he feels completely okay.