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A 31 yr old, male patient, thin, fair complexion came with the chief complaint of anxiety disorder, tics on Rt. Side, eczema.

He has eczema on and off since age of 13 yrs, tics in various parts of  body since age of 13 yrs.

 

Initial Visit September 21th, 2011:

Doctor observation: Very objective, descriptive and organized in describing in health related problems in the case record. With lot of questions prior making the appointment.

{D: Doctor; P: Patient; Hg: Hand gesture}

 

D:  What is bothering you the most?

P: Anxiety, Obsessive at particular things like Stains on my body clothes

If I see people I will be conscious. Fear of as if I am dirty or unclean infront of people

Obsessed with lawn maintenance-The weeds taking over my lawn. Checking the weeds right away instead of waiting for two weeks as the weeds go away in two weeks.

I need to Control on things

Feels as if I have two parts in my head.

The Lower part is calm, relaxed and the upper part is all tangled, dense.

Extreme sensitive to other people. Over stimulated easily- too much light, noise

Takes lot of information I do consciously it is constantly where as normal thing is people do all this at subconscious level and not aware of it much.

D: Describe what you are saying little more?

P:  Hard to be with more than 2 or 3 people. My mind speeds up. I think faster and faster, obsessed

D: Talk more about that obsession

P: When I am anxious I look for perfection e.g lawn, desire to be perfect, clean, smooth, not looking old and all this happen when I am stressed. Need to be everything perfect.

At other times when I am relaxed I like imperfection.

Two different voices – one is intelligent and other is obsessed which is so strong, powerful that my lawn is going to be wrecked, my clothes are wrecked?

D:Wrecked means? 

P: Rough weeds, grass won’t go and In powerless, nothing can be fixed.

When I am stressed I feel my body is weak and withered, sickly, cheeks gone, I look I feel I have cancer, skin color is pale

When I am relaxed in mirror my body is strong, my body fills T-s hirt when I don’t I am bony and thin and my clothes are lying on scare crow- stick.

D: Tell more

P: Buying new clothes or shoes is difficult and confusing.

If it is a new shoes…I take them home and my first reaction is it is wrong one may be it is wrong size or rubs the toe and that bothers me a lot constantly for couple of days and I  occasionally returns it but I gradually convince myself that they are good choice.

I do meditation to convince myself.

Doubts even after meditation….all this goes up to one month and then I will be accustomed to it and fine.

Confusing my own perspective.

Few things in my life calm me down- meditation, having time to myself

D: What makes you happy?

P: Being in nature either alone and with few people, outside in thunderstorm in middle of woods, then while I am at home.

D: What happens when you are at home?

P: In home I feel all of the corners feel like poking me physically …as if physically leaning at sharp edges.

D: How do you feel when you are in city?

P: My stomach is tense when I drive in city.

Going to small towns – little tense

Suburbs – feels the same sensation as perfect lines, sharp corners.

Diaphragm is clenched (hand gesture) on rt side. Worse getting in to city. Better by decreasing the stimuli and to be in nature by alone and I will be in peace.

D: Tell about your tics?

P: Have had a tic in various parts of my body since around 13.  Has been in Right eye/face for past ten years; before that, it was sometimes in my neck, shoulder, stomach, hip, as well as a vocal tic in 5th grade. Worse in public. When I am alone I don’t feel like I am judged or watched.

All my tics are on right side (90%) My tics stop when I play music.

Listening to music-excited if it is loud, passionate,  I feel emotionally…but I am worse

I love playing and it gives me relaxation.

D: How is your sleep?

P: Not terrible, but not great.  I need to wear earplugs and sleep in a separate room to fall asleep (my wife and daughter sleep together in the bed, and while the bed is physically big enough for the three of us, I simply don’t relax or fall asleep).  Without earplugs, my mind simply won’t “turn off.”  When I am not extremely exhausted, I frequently wake up around one and a half hours before I need to, and simply can’t fall back asleep.  It is also often difficult for me to get up in the morning (this has always been the case).  When I am asleep, however, I tend to sleep deeply.

D: What dreams do you get?

P: Dream, I have to pick a dentist and in my dream I felt I was disappointed, frustrated. I think he told me that I needed a procedure that I didn’t trust. The previous dentist mentioned that I have 8 cavities but my aunt who is a dentist said I have none.

D: What was the experience in the dream?

P: Powerless, lack of control.

D: What else?

P: I love music. I am not a great performer, I became self conscious and make lot of mistakes.

The more the familiar I am the less the stress.

Worse by travelling as everything is new and different to handle.

Frequent checking…Turn of stove, lock the door.

  

Below are the physical generals and particulars of the patient that were considered as characteristic:

 

  • Diarrhea, particularly when very worried about something and anticipating. 
  • Tip of nose is cold in winter.
  • Hands and feet cold to touch.
  • Better when head is  wet cool
  • Worse from sunrise to sunset.
  • In hot weather: anxious and unprotected; in cool, cloudy and rainy  weather: pleasant and protected
  • Covering makes him feel safe and cozy
  • Amel night-very happy and comfortable.
  • Thirstless
  • Grinding of teeth
  • Talking and walking in sleep in childhood
  • Hot sensation
  • When angry want to hit and kick things.  Or, heat/burning sensation inside, and eczema flares with prolonged anger.

 

 

Case evaluation:

  • Image conscious, worried about what people think about him. insecure in groups of people
  • Delusion being judged by people
  • Anticipatory anxiety/public fear
  • Confusion
  • Delusion all of the corners feel like poking, sharp edges.
  • Anxiety going in cities, perfect lines, sharp corners.
  • Delusion Diaphragm is clenched (hg) on rt side
  • Delusion being watched
  • Fastidious
  • Delusion: Brain's Lower part is calm, relaxed and the upper part is all tangled, dense
  • Delusion not attractive
  • Delusion, dirty
  • Sensitive to noise (dislikes)
  • Difficulty in Balance in life, struggle to get balance
  • Lack of control and need to control the things
  • Life's seems to be too much weight

 

Repertorial Totality (From Kent’s Repertory):

  1. Mind, Delusion, corners of houses seem to project so that he fears he will run against them while walking in the street :
  2. Mind, Fear crowd in
  3. Mind, Fear in public places
  4. Mind, ANTICIPATION, complaints from
  5. Mind, Sensitive noise to
  6. Generalities, daytime agg
  7. Extremities, Coldness, hands
  8. Extremities, Coldness, feet
  9. Nose, Coldness, tip of nose
  10. Grinding, sleep during

Classic reportorial analysis showed

Argentum Nitricum scored 14 points,

Arseninc Album 15 points and covered most of the symptoms but fear in public places and complaints from anticipation is not prominent in this remedy.

 Gelsemium 9 points and it didn't cover the peculiar symptoms like delusion of houses projecting and poking sensation

The case was also solved using the Sensation Method:

 

Source considering Mineral Kingdom:

Image conscious

Organized

Straight perfect lines and edges and corners

Confusion

Insecurity-security

He lacks control over things

 

Miasm:

Need to control on things "Cancer miasm", avoid or cover up is  "Sycotic miasm" and hurried & intense nature is "tubercular miasm". This patient is pointing to  all the above three miasms.

 

Mineral kingdom

Row 5

Creativity & performance

Need to explore the new, be creative, perform and be appreciated need to process the information & come to conclusion, to analyse, to improvise, to invent, to devise, to strategise, to plan ,to solve.

Row 2

 

Separation : he is an entity. “ Am I part of something or am I separate”

Carbon, oxygen, nitrogen : the separation develops further.

  “ I must break this attachment and be completely separate “

 

For this patient the theme was to do with performance, and to do with the nitrogen theme of separation. Hence Argentum Nitricum was prescribed on the following symptoms:

 

Indication of Argentum Nitricum :

It is compound of silver of argentum whose main theme is performance and nitrate whose main theme is “ feeling of sudden danger. The two things come together in Argentum nitricum , so main theme becomes “ Performance in sudden danger or crisis “

 

There Is feeling as if the person will be accepted only if he can perform at the time of crisis. There is feeling of being neglected and despised if he does not perform at the time of crisis. They are trouble shooters of the highest degree and see their role as that, feeling very much neglected and isolated and feeling of failure if they cant perform in crisis.

 

Situational materia medica is patient has to struggle and nobody is going to help him, he is trying but not succeeding.

 

This situation arose from being trapped alone in some circumstances and trying desperately to find a way out.. but these fears are due to tremendous sense of fault within which he is trying to cover it.

 

It is important for him to keep control in this situation and find his own way out of the problem. Fear of loosing control. Fear of high places, fear of narrow places.

Anticipation

Fear of failure.

Fear of falling.

 

Patient tries to get out of the trap impulsively. He feels there is no way out. Another situation is at the stage. The patients are anxious to go on stage. But when persuaded, they feel isolated and trapped.

 

Argentum has lot to do with suspense. They like challenging jobs in order to overcome the fear.

 

When they feel trapped they almost do suicidal, impulsive things.

Rubrics :

Ailments from anticipation

Delusion, corners of house projecting so that he fears he will run against them while walking in the street.

Del, deserted, isolated

Fear of failure

Fear falling of

Fear narrow places .

High places agg

Time passes to slowly.

 

Dosage and Potency: Argentum Nitricum 1M was given in medicinal solution split potency. As per sensation method he is at delusional level so given 1M. Remedy was occasionally repeated, when the symptoms relapsed.

 

Follow up in person after 2 months

 

Doing good over all in all aspects. About 75% better with his anxiety and obessive nature.

 

Small red bumps that came up

 

Able to read when music is on- this never happened in life time

 

Tics occasionally (Covered by Arg nit)

Wake up in morning very tired.

 

He said he is using once a week to over come his anxiety as he needs to take care of his daughter who is a infant which again triggering his anxiety.

 

Case Evaluation on follow up: Since the patient has made great improvement with the remedy and there is a external stress demanding him to repeat frequently then advised him LM 6 potency daily which is equivalent to 1M potency.

 

Follow up after 6 months

 

Much improvement

Spring coming  anxiety issues pop’s out

Definitely much better

Sometimes clothes, yard thing bother me but not much.

I feel I am continuing to improve

Prostatitis has come back, started 3 wks back…seen intermittently

Doctors prescribed Antibiotic, but he didn’t take

Very slight burning while urinating

Normal color

Blood work was done…waiting for test results

Thirst  ok as currently doing religious fast- sunrise and sunset don’t eat or drink since 2 wks.

How is this prostatitis effecting?

It doesn’t bother me a lot…2 or 3 in the scale 0-10 where 10 is more and 0 is less.

Mild discomfort…don’t want to make it worse, I am afraid of it  so wanted to take precautions.

Dreams-now I remember my dreams before treatment I never remember.

This morning I had dream remaining calm, outside things not effected me. Trying to get lid out.

Experience is good.

Able to turn inward, for calmness….in a half awake state.

Family vacation – better than in the past….enjoyed it . new place….

During vacation frustrated out little more with my anxiety- dirty clothes and then repeated the remedy and felt good after the remedy.

80% anxiety better on daily basis….which is a good sign.

Sleep is good.with out ear plugs I am sleeping now.Before treatment I have to keep ear plugs to sleep.

Right tic is improved

Reduced in take of remedy, am only taking as needed.

 

Case Evaluation at 6 month follow up: Patient is continously improving with the remedy. He has seen all positive changes. Even able to remember dreams that clearly shows that he is getting connected to his inner consciousness.

 

Advised Argentum Nitricum 10M single dose to act more deeply.

 

Follow up after 1 year

 

Doing great. More than 85% relief. Occasionally repeating Argentum Nitricum LM6.

 

Until now the client is doing good occasionally taking Argentum Nitricum (three months back he needed Sulphur 200 single dose as a intercurrent remedy. Has uncontrollable diarrhoea every morning).

 

 

 

 

 

 

 

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Very educative and informative case, but I want to know something more about sensation method, how you able to decide that given case or any other case belong to mineral, vegetable or animal kingdom. 

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