Creating Waves of Awareness
On 8th oct 2005, a powerful earthquake was there in India and parts of Pakistan. it is a case of a student who was in school while the earthquake was there.
Case of PTSD
Date: 10 --11--2005
A) Patient’s Biodata:
Name: S Singh Age: 12 years Sex: M
Martial Status: Single
Residence: Rural Occupation: Student
Socioeconomic Status: Middle
B) Presenting Complaints:
Fearful; Vertigo; Sleeplessness; Irritability; Startles from slightest
C) History of the present Illness:
All complaints started since 8th Oct 2005, when the Earthquake struck. He was in the school when the quake struck & there was stampede in the class. In this process he fell down and received some injuries also. The walls of his class cracked from this. It was his first experience with earthquake of such intensity and was it was full of horror for him.
Has constant fear of earthquake happening again.
Is sleepless due to frequent waking. < From slightest nose.
Since the quake has struck, he prefers to remain outdoors even sleeps in the open.
Irritable from noise from. Shouts from anger.
He startles from the slightest noise and touch.
Vertigo / Dizzy feeling which started after the earthquake.
D) History of the previous Illnesses: NAD
F) Personal Details:
APPEARANCE: Lean Thin Tall
SLEEP & DREAMS:
Sleeplessness from disturbed sleep from fears, slightest noise,
Dreams: Frightful, waking him
Thermal state: Hot
G) Emotional State:
Anxious, Fearful, Apprehensive.
I) Life situations and circumstances:
Only son of his parents. Both parents are working and the patient is cared by his grandparents. Is described as very sensitive child by the parents. Gets scared easily. Good in studies and extra-curricular activities. Like to play cricket and computer games. Has lost interest in things which he used to enjoy since that episode.
J) Body Language:
Facial expressions: Anxious +
K) Physical Examination General:
Temp. N No Jaundice
Pulse No Cyanosis
No Oedema No Lymph nodes enlarged.
L) SYSTEMIC EXAMINATION:
RESPIRATORY NAD PER ABDOMEN NAD
CVS NAD CNS NAD
Diagnosis: Post Traumatic Stress Disorder.
Date: 10/11/2005 Sukhwinder Singh
1 MIND – FRIGHT – complaints, from 46
2 MIND - STARTING - easily 39
3 MIND - STARTING - sleep - during 82
4 MIND - STARTING – fright, from 53
5 MIND - SENSITIVE - noise, slightest to 18
6 VERTIGO - FRIGHT, after 3
Op. Phos. Sil. Nat-m. Nux-v. Kali-c. Acon.
12/6 12/5 9/5 11/4 9/4 9/3 9/5
1: 3 3 3 3 2 - 3
2: 1 3 2 3 2 3 -
3: 2 2 1 2 2 3 1
4: 1 2 - 3 - 3 2
5: 3 2 3 - 3 - 1
6: 2 - - - - - 2
Opium 1M 1 dose. Placebo t.d.s for 2 weeks.
Better. Vertigo is almost fully better. Temper is also better. Now gets comfortable sleep and the sensitivity / starting is also much better.
Placebo t.d.s for 2 weeks.
Better by more than 70 percent. Vertigo is not there. Appetite has improved. Constipation is also better. The frightful dreams are less now and not much disturbing. Placebo t.d.s for 1 month.
The patient is now better in all respects. His appetite & constipation are better. His temper is now under control. The sensitivity to noise is now normal. The starting from sleep and frightful dreams are also not disturbing now. Placebo t.d.s for 1 month.
Better in all respects. Placebo t.d.s for 1 month.
Better. No complaints on any levels. Placebo t.d.s for 1 month.
Discussion of Case No 3
The case presented to us with Post Traumatic Stress Disorder which was there due to the earthquake in Northern India on 8/10/05. This case had a strong mental causation, which deranged a perfectly healthy child to an abnormal one. So Kent’s repertory was the best choice for repertorisation.
On Repertorisation, the following drugs came up for consideration
Op 12/6, Phos 12/5, Sil 9/5, Nat-m 11/4, Nux-v 9/4, Kali-c 9/3 & Acon 9/5.
From the following drugs, Op and Acon were given preference as they covered the Causation and “Vertigo, fright after”. Opium was given preference over Aconite as the “Fear of death, predicts the day of death”, a grand general of Aconite was absent in this case. Also on referring to Knerr`s repertory in the section Mind following rubric was found in favor of Opium i.e. **MIND - After fright, fear of the fright still remaining. On the basis of acute condition of the mind, high potency of Opium i.e. 1M was selected and given as single dose. As continued progress in the improvement of the general state continued, Opium was not repeated.
Hahnemann refers to this type of diseases as “Mental diseases appearing suddenly as an acute disease in patient’s ordinary calm state caused by some exciting factor” in § 221 of the Organon. He explains that in this type of disease, an insanity or frenzy suddenly breaks out as an acute disease from the patient’s usually quite state. This may be caused by fright, vexation, drinking alcohol etc., and attributes it to Psora. He recommends that during acute phase, deep acting remedies are not needed but remedy that corresponds to the acute picture is needed. Hahnemann stresses that after the acute state has subsided, these patients should be followed up with Antipsoric treatment to prevent recurrence & if this is not done, a worse attack from a much slighter cause is bound to follow which will be more difficult to cure.