Mr. K. K. Aged 21yrs came to me for treatment of a corn on his palm on 29th Aug, 2013. His conversation seemed quite energetic and excited. I observed this in all his follow-ups too. He was always in a hurry, excited and energetic, always busy in some kind of work.
Corn on r. palm since 3 months. He had much stress three months back when this corn-like eruption started developing. The eruption looked like a nodule, may have been a wart or something else. On examination, it was dry, hard and painful. The image of the eruption taken later is shown below:
Image 1: Eruption, wart like on palm of right hand, taken on 26-Dec-2013 in bright light.
- Pneumonia at birth. Recurrent until 5yrs of age.
- Jaundice after birth.
- Recurrent throat infection <draft of air+++, getting wet in rain+++, whole chest feels congested, pain in swallowing food, Pain in talking. Irritable with AWOTA++ (anger when obliged to answer). Fever=weakness+++, leg cramps at night etc. He routinely also gets leg cramps at night without fever also. He says that whenever he goes to an Allopathic physician for this complaint, they say that he has Calcium deficiency and prescribe him calcium tablets.
- H/o recurrent tonsillitis.
- H/o Multiple homoeopathic treatments. Generally amel. by Belladonna in past.
- H/o nausea < stage fear, emotional excitement, bad news.
- Broods a lot over criticism, even falls sick over it.
- H/o fracture.
Mother: Bronchitis, Stress, Allergies/Cough, AKT was given before he was born.
Father: Vaso-vagal attack. Syncope.
P. Aunt: Asthma, Cannabis, Cough. Loss of vision/hearing.
Siblings: Sisters: Tubectomy due to infection. Cholecystectomy. One of the sister is deaf and dumb. Another sister has OCD for washing hands. Depression. One sister is very marasmic. Another sister had two still-births due to lack of liquor amni.
Appetite: N. Prefers hot food++.
Thirst: Thirstless. 1 ltr/day. Aversion to water++ (water feels like medicine). Cold drinks agg. = cough, throat infection. Warm drinks?
Desires: Spicy+++. Vegetarian. Bitter-guard. Salt (N). Paneer++++. Fat food++. Sour+.
Aversion: Sweets++, Fruits++. Milk++.
Micturition and bowels: N.
Sleep: 8 hrs sleep is a must or he becomes dull. Feels better with a 2-3hrs sleep. Never sleeps during day. Dull even on waking. Active b/w 10am – 2pm. Sleeps on abdomen++. Covers must+++, in any season.
Dreams: N. Earlier was very fearful of dead bodies, accidents, fire. Trembling on seeing fire etc. But no fears after coming to college. Fear of touch of animals. Preferably wears a cloth only once. Always scolding others+++ at home to maintain cleanliness. Pain in abdomen < overlifting (This weakness after recurrent Pneumonia). Anxiety about health of family++.
Perspiration: Scanty. Rarely, on forehead. Offensive in arms. No staining.
Habits: Exercise. Travelling+++ long tours; new places+++. Spends time with family and listens to them.
Bathing: warm water only.
Covers: must. Even wears warm clothing on being slightly chilly also.
Fan: must, all year through, or else feels suffocated.
A/c: irritation. Recurrent cough. He enjoys singing etc, but not able to, due to cough.
Prefers open windows.
Season: Enjoys winters most. Recurrent fungal infection in summers.
Sun: Headache and weakness since childhood. Cannot tolerate heat.
Moderately built, good height. White patches on penis (not examined). Long nails, white patches on nails. Keeps nails clean+++, would clean nails, not only his but even others; expects so much cleanliness.
! Occasional bitter-taste in mouth.
! Enjoys making friends+++; even travels long distance to meet them.
! Feels bad when criticized, easily hurt, brooding, even falls sick because of it.
! Cannot see anyone in pain+++, would spend hours awake by the side of his friend, alas in the end, his friend died.
! Once he puts his mind to get anything, he gets it.
! Catatonia from anxiety.
! Delayed in work.
! Forgetful+++ – misplaces clothes in hotels, mobiles, buys objects and pays for them and leaves them in the shop.
! Easily absorbed in thoughts.
! Needs to read at least twice, writes and learns only in a sequence.
! Rarely fights through conversation, but directly becomes physical.
! Once he starts a work, completes it then and there. Not at all religious or superstitious.
! Never carries cash (I think out of fear of robbers).
! Easily talks to authorities, principal of his college etc. He is leader of his group at his institution.
! Constantly talking about his friends death. Feels very sorry for him. Talked about it at least 10times during the whole interview.
! Has seen much pain in life like murders, fires, mutilated bodies, families killing families etc. Very very sensitive to it++++.
! Since his friend’s death, difficult to study in that room (or anywhere else also as he was his study partner).
! No problems with using public toilets, no problem with company either. Uses public toilets only if they are clean.
! Not fastidious about time.
The remedy for the case was not at all evident to me throughout the interview. All I did was to go on adding important symptoms to the repertory sheet all along the interview and hoped that the remedy would become evident as more symptoms got added. But that did not happen here. Generally VES is quick to show me the drug, but since I had taken too many symptoms here, even VES was suggesting many remedies like Bar-ac, Tub, Med, Bell, Calc-p, Aloe, and Causticum Since Causticum was the first drug on rep. sheet I decided to cover it first. On reading materia-medica, the remedy become evident to me and I decided to go with Causticum.
I would like to share some of my observations from past cases which were also found in this case which helped me choose this drug over others:
i. An important remedy for warts on hands and face.
ii. Extreme fastidiousness. Gen. Arsenicum or Syphilinum are the remedies chosen for such fastidiousness, sometimes even Nat-m, but here the person has extreme concern for others and is not fastidious about time. As for Syphilinum, the kind of fear of infection is extreme, but here it deals more with hygiene or order.
iii. Forgetful memory; this again is peculiar for this drug where he makes purchases and forgets to pick them up. It is sometimes seen (in other cases) as a habit to check or recheck things like locks, valuables etc.
iv. Sensitive to criticism is not noted in repertories for Causticum but such has been my experience and should be added. These people are extremely honest and thus in turn they tend to feel great about themselves, even need to be rewarded for when they are and when they are not. If the award goes to another, they feel so humiliated that they could even fall sick. Many kinds of emotions can be the cause for the onset of Causticum Eg. ailments from anger, rejection, grief, criticism, reprimands, death of loved ones etc.
v. Extreme intolerance to injustice in any form. They have extreme concern for the weak, for strangers, the ill, and they go to great lengths to help others. The key feature is that they will help until the problem is solved and so it’s not a mere show of concern as in Natrum mur.
vi. The kind of excitement seen in this case is also found in Causticum and K-phos.
vii Apart from the above symptoms, a unique feature that makes a Causticum is that these people have seen lots of sufferings and pain in their childhood. This actually makes them into honest and hardworking people where other remedies may go into other reactions. I would like to particularly talk about Flour-ac here which also has a similar background but here it results in enjoying life with money and sex, rather than being ‘just’ (as in justice) as happens to Causticum cases.
viii He cared for his friend until death and was extremely affected even after his death, whereas his other friends continued to have normal lives. Such a care may belong to Phosphorus but since Causticum clearly comes up on repertorisation, it is the obvious choice in light of his warts, memory and fighting with even seniors (here – the Principal) for the welfare of his friends.
ix. When I read materia medica, I found that even the past history of this person was consistent with Caust complaints.
I decided to go with Causticum, and the follow-ups, as they happened are given for your study along with the images taken before and after cure.
Rep. Sheet 1: The last two symptoms are grouped together.
12 – Sep – 2013: I had asked him to collect medicine next day, and he ends up coming after 2weeks. ( I already have a feeling that I will not be able to follow-up this case for long as he doesn’t seem to be regular with treatment.)
Rx: Causticum 30/1dose. Rubrum 30 BD X 15days.
13 – Sep – 2013: Abdominal colic since 2 days, since he ate eggs, 2days back. Motions 3-4times/daily. Flatulence. Stool <eating after++. Fever yesterday evening. Loss of appetite+++ <on looking at food. Even water tastes bitter++. He has developed sudden deep fear; much anxiety+++. Sleepless all night, just turning and tossing in bed all night. Old c/o cough has come back. Weakness, dullness, generalized bodyache.
Rx: Chin-ars 200/1dose/sos.
So, he comes back next day and this is not due to Causticum. The acute was already developing and Causticum didn’t have any action here, else, the complaint should have actually been cured after Causticum 30 was administered. But then, another question that arose was, if Causticum did not act, then is Causticum actually the remedy of the case? We all see many acute cases in practice. But, what surprised me is that when he came to collect medicine yesterday, he did not complain of colic etc. probably because the pain was not severe; but today, he has so many symptoms to offer that the remedy is totally clear. Hence, Chin-ars was prescribed.
26 – Dec – 2013: Got operated for appendicitis on 16th Nov, 2013. He says that three members of his family died in past as appendix burst, hence parents were anxious and got him operated on. Now, the eruption (wart) on palm is more dry, hard and painfull++. However, since operation, stiffness of neck is reduced very much. PHOTO TAKEN.
Rx: Causticum 30/1dose. Rubrum 30 BD X 15days.
He talked nothing about his earlier acute attack and when questioned, he did not give me satisfactory answer, so I am not in a position to say if Chin-ars acted or not. Also, since his operation, there have been some changes in symptoms, but I decided to go with the drug I had chosen earlier from the full-case. I still had faith that it was the right choice. Clinically speaking, this would be considered the first prescription as I’ve no info if last two prescriptions had any action or not.
10 – Jan – 2013: Feels very much relaxed about everything now. The excessive passion and possessiveness along with brooding is over. He used to brood over a criticism for 3-4 days constantly, but now he feels relaxed about everything, careless+++. Now able to let go of things, doesn’t care at all!!! (I am not able to understand if this is a good reaction or a wrong one. I analysed it: Until now, he cared too much for other people’s opinion, hence, for cure to take place, the symptoms have gone totally in the opposite direction. I decided to wait as it was clear from the patient’s words that the remedy was acting and he was feeling overall better).
Rx: Rubrum 30 BD X 15days.
28 – Jan – 2014: Today he showed me that his wart fell off after starting the last medicine. He feels very relaxed now as there is no pain now. His memory is weak…, he is so careless that he often forgets his laptop in bus or train, has misplaced his mobile in past many times and so on. I asked him to continue treatment, but sadly, once his wart fell off, he has not returned for follow-up.
Image 3: Eruption, wart like on palm of right hand, cured, fallen off. Image taken on 28-Jan-2014 in sunlight.
1st April, 2014:He visited me again as the cramps in his legs were coming back. Also, he was again developing mild anxiety and brooding again. Just to check the concept of Causticum that I had formed in my mind, I decided to ask him if I could publish his case in a Homoeopathic magazine. He replied , ‘Why not sir? How will we be able to help our fellow physicians if we do not share our cases?” He did not worry even for one moment about privacy concerns as generally other patients do.
Rx: Caust 30/1dose. Placebo for 1 week.
It is my belief that this case for complete cure to take place will go on for at least 2yrs, but the good aspect is that instead of taking allopathic medications, he now comes for homoeopathic medicines and the remedy also has a good hold of the constitution. Thus I have good hopes for this case in the future. However, since chief complaint was cured, I decided to send it for publication.
I shall be happy to have your feedback on Causticum in any case that you may have cured with this drug. Thank you.