Devang Shah, Armeen Jasavala, Alifiya Merchant of – ‘the other song’
This Case was previously published in NJH in March 2017
This is a case of a 38 year old female who consulted Dr. Devang Shah for recurrent attacks of allergic rhinitis. She first consulted him on 21st July 2015. Her attacks were triggered by exposure to cold in any form and got worse from bending her head or moving it. Every time that she got coryza, she’d develop an itching or scratching sensation in the nose and throat followed by watering from eyes especially after exposure to dust. Thereafter, she would feel exhausted and would be averse to do anything. During the attack, she felt better by sitting and after eating. Besides, she frequently got a headache on account of the cold wherein she felt better by applying pressure and simply switching off all the lights and lying in the dark.
Following is the case interview between the Doctor and the Patient.
*The following case has been condensed and grammatically altered for comprehension purposes. (Index for abbreviations D – Doctor, P – Patient)
D: Tell me about yourself?
P: I have lot tensions in my life.
D: Talk about your tensions?
P: Husband’s health. He is having high sugar and that makes me worried. I fear something may happen to him. Hence, there is a lot of turmoil going on within me.
D: When you say turmoil what you mean, what is the experience of this turmoil?
P: It is hard. Something piercing like a knife does; being poked as though 100 arrows were going through you.
D: Just describe this a little bit more? What is the experience of this pierce, poked and arrows going through you?
P: What comes to me is blood, unbearable pain. It gives me headache. (She starts to have some headache at this point)
D: Describe this experience of pain a little bit more?
P: I go numb. No feeling. Completely dead. It’s the end. Being lost
D: Describe this numb a little more?
P: Vacuum, stillness, standing water, no feeling, no emotions.
D: Tell me what dreams you get?
P: Air crash of my mother
D: What is the feeling here?
P: Blame myself Sorrow. Disbelief of what has happened.
D: What is the feeling without mother?
P: No foundation, hanging, have no-one, alone as if a tree was cut off from its root.
D: What is the experience there?
P: It is over. It is dead. Nothing is left. Empty. The tree goes dead. Its numb.
D: What is the opposite of this?
P: Blooming with energy, happy, peace, and oneness. It is life.
D: Tell me one stressful situation of your life?
P: Death of my father (Weeps)
D: Tell about this?
P: More than the death doctor it is how he landed into that situation was difficult for me to see him like that.
D: What did you experience?
P: I felt helpless. I felt a lot of pain. Felt weak
D: Describe this ‘weak’?
P: No strength, fragile, loose, no velocity, dead. D: Tell me in news movies or serials what are the things that you are sensitive to?
P: Blood (spontaneously) Kids getting hurt. Someone is being cut through. A Serial killer killing his mother.
D: Tell me about this. What is it that you are sensitive to?
P: I am sensitive to ‘pain’. When I watch such scenes, I can feel the pain one going through me. I cannot take any form of pain. I am very sensitive to it.
D: What you mean, what is the experience?
P: Pain like someone cutting through something or poking with a knife. This is exactly what I told you earlier when I go through the stress of my husband’s health doctor.
In her generals, she desired chaat (mix of sweet salty and spicy). Her water intake was less on the whole. She perspired profusely especially in her neck, axilla and palms. She was comfortable sleeping on her sides and was thermally sensitive to cold.
Analysis of the case:
In the above case, the most striking phenomenon about the patient is her ‘Sensitivity towards pain’. This is confirmed in various areas of her life where she came back to the same sensitivity. Since ‘Pain’ comes up so peculiarly in every situation of her life, it becomes her ‘Global Sensation’. In this case, since the ‘system’ is more clear than the symptoms, the ‘Sensation Approach’ would be ideal to analyze and solve this case. The ‘Sensation Method’ was devised by Dr. Rajan Sankaran, wherein he has classified Homeopathic remedies into kingdoms, sub-kingdoms and miasms very artistically by which discrimination between remedies has become so much easier.
When we examine different situations in her life like her husband’s health condition, dreams, incident of father’s death or her reaction while watching bad news or movie scenes which have bloodshed and violence, she experiences a state of numbness, no feelings, as though dead, 100 arrows being poked or pierced through one’s body, deepest experience of pain.
The various words used by the patient to express her sensitivity towards pain are as follows:
- No feelings
- No emotions
While she experiences all of the above, she also expressed the opposite sensation of the same like
Through the above words and experiences, we see the quality of ‘sensitivity’ and ‘reactivity’ in the patient. She clearly experiences the opposite modalities of the sensation; one is that of pain, numbness, dead, without emotions, pierced and the opposite of which is peace, blooming, oneness and life. By this we can infer that the patient belongs to the Plant kingdom, Papavaracea family, whose main sensation is increased sensitivity towards pain, violence, bloodshed and feeling of numbness, murder. The Patients needing remedies from the papaveraceae family focuses more on the pain than the type of pain. Their entire focus is on the intensity of pain hence we generally don’t get any specific type of pain like for example in compositae. In this case too her area of sensitivity was more on pain and the opposite of it which is numb dead without life.
Now when we look at the repertory sheet we see the following remedies come up prominently. Nux v, bryonia, cocculus, chelidonium, spigelia, arnica, ledum pal.
- 2164 < cold in general (p) 
- 2034 < bending over, while (p) 
- 874 < movement, aversion to (p) 
- 2608 > sitting (p) 
- 2174 < shaking head (p) 
- 2515 > eating, during (p) 
- 2586 > resting, while (p) 
- 2509 > pressure, external (p) 
- 2553 > lying position (p) 
- It is interesting to see that all the above are plant remedies. Nux Vom and Spigelia belong to same family that is Logainaceae and we have Chelidonium, Arnica and Ledum. Interestingly Ledum belongs to Theales family and the sensation of Theales is injury to nerves, penetrating, and sharp punctured wounds. However, her general modality is worse by cold and Ledum in general is better by cold and secondly she does not have the sensation not of being punctured or stabbed or penetrated as seen in Theales
- The remedy given to her was Chelidonium 200 bd for 2 days. Firstly, we see it coming up strongly in repertorization. Secondly, when we look at it from the system point of view and we see the sensation of ‘Papaveraceae’ coming up very clearly in the case, and we know Chelidonium belongs to the same family. More so the peculiar modality of worse cold and better by heat is confirmed by Phatak and Boger in their respective Materia Medica
- She has been on treatment for the past 9 months and she is much better.
- She required repetition every 2 months for the initial couple of months after which she did not take medicines for a long time.
- She came back with a relapse 6 months after and then she repeated a few doses.
- Her sensitivity to pain had lessened to a great extent and her ability to cope with difficult situations had improved by 60-70% according to her.
- Since her physical complaints were much better she made infrequent visits but overall continues to enjoy good health till date.
We learned the following things from this case. When there are clear cut symptoms, the first step is to elicit exact symptoms and then form a totality based on these symptoms. The next step is to have an overview of the remedies suggested but not getting fixed or attached to any of them. Then, as directed by Hahnemann and Boenninghausen, go to the mental state. Use the advancement of sensation method and see where it leads to. When the symptom and the system both suggest the same remedy then chances of failure are minimized. Lastly going to the materia medica and using that as final court of appeal, will help to seal the deal.
Trap for Mistakes:
In this case we could also have gotten trapped by simple mistakes, including assuming the patient was from the Compositae or Theales family. What we must do to avoid these prejudices is to focus on the symptoms and not go haywire. Going by only rubrics, we would have given Nux vomica, as it is a good remedy for colds. But ultimately, we must match the state of the patient to the remedy.