| A 39-year-old man presented in August 2004 with asymmetric joint pain and swelling in the fingers; his complaints had already been diagnosed as seronegative arthritis. He has pain in the right hand, the elbow and the right hip. The pain increases at night and is worst between midnight and 1 am; he uses an ayurvedic spray (Reli) to relieve the pain. The pain occurs about once a week and he can sense in advance when an attack will come and uses the spray prophylactically. He finds it painful to bear weight on his right side, so he has to pull himself up when getting up from a seated position. Eating sour foods, especially unripe mangoes, aggravates the pain. He has a slight tendency to stammer, particularly when he meets someone new. | |
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| Dr.: "Tell me more about your pain!" | |
| Pt.: "It started in the fingertips when I was sixteen. The slightest touch made everything worse, and my fingers turned red. At the moment the pain is very severe; it is like an ulcer inside me, I cannot bend my joints! It feels as if I had been struck by a blunt object, as if the blood inside me had congealed. It is worse when my hand hangs down, worse on touch and better when I shake my hand. When it started I cried from the pain and wondered what the future would be like. At present I can endure the pain, but I do not know what will happen next. If I tell my wife she will worry a great deal. I know it will get worse, so I keep quiet; I can remain calm, even if someone cut me with a knife, I wouldn't even say "oooh" (weeps). I know the illness will remain, I cannot relieve it, so I must endure it." | |
 Breach of the dike on the Elbe 1825; Flooding |
When the pain first came I was asleep and had a dream. In that dream I was sitting in a boat in a flood and saw many people swept into the water and drowning. I saw myself trying to rescue people. I rescued someone on the right side of the boat, then went to the left side and saved someone else. I watched myself, and with each movement the pain in my hand became worse. It was a pain as if something were broken, as if the hand were frozen from the inside. I could hardly move my arm, yet I forced myself to do so. |
| Slowly and with great pain I moved the arm from right to left. When I sat still I had no pain, but there were so many people wanting to be saved by me. From all sides they cried for help, it was unbearable. But the worst thing in my dream was the pain; it absorbed me completely, it was boundless, unbearable, more than I could bear and I screamed with pain. At that time I tried to tell myself: "This pain is here and will always be here, so forget the pain and concentrate on saving these people's lives!" | |
| It is important to understand the patient's psyche; even though his physical illness is arthritis, what matters is his pathological way of coping with his problem. He feels there is no hope, that the pain will remain, and that his only way of coping is to endure the pain. | |
The pain is unbearable and the situation he is in within his dream is equally unbearable; it is a very difficult situation requiring superhuman effort, which he takes on successfully. We observe his sensitivity to pain and how he tries to control his pain in order to save people's lives. This kind of coping indicates the cancer miasm: a situation that has gone out of control, that exceeds one's limits, that places high demands and requires superhuman effort — this is precisely what we see in this dream. The second thing we must understand is the way he uses his dreams to describe how he copes with pain, how intense the situation is in his perception and what high demands it places on him. This is the level of imagination and fantasy.Now we must search for and explore other uncompensated areas of his life to understand his experiences. When we find the right trail we will encounter similar experiences to those we already know. If something entirely new appears when we explore another area of life, this either means we only investigated the first experience incompletely or that we are on the wrong track. In such a case we must first try to understand the newly discovered process until we have correctly grasped the whole life principle; only then can we draw on earlier experiences and find the missing link. |
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| When he speaks about his pain he repeatedly says: "It is completely out of control, it exceeds the limits of what is bearable. If it became any worse I couldn't walk, I would be bedridden and that would depress me terribly!" | |
| Dr.: "Tell me more about yourself." | |
| Pt.: "My main aim is to stay fit. Since childhood I have practised skipping rope, 400 times per session." | |
| Dr.: "Is there an event in your life that had a strong effect on you?" | |
| Pt.: "Yes, and even today when I think of that incident tears come to my eyes. One day I found my daughter, under severe exam pressure, lying unconscious on her bed. Her eyes were wide open and her limbs were extended, but she lay motionless (he has tears in his eyes). It happened right before my eyes. I thought: 'What if something happened to her?' I was in shock. She was suffering and I could do nothing, I was completely helpless. It exceeded my imagination, I could not bear it." | |
| Dr.: "Tell me more about this shock!" | |
Pt: "It was so unexpected, suddenly something so painful occurred. I had to watch someone I loved so much suffer and that anything could happen to her, that was so shocking for me. Another incident: "I was walking with my mother; I held her hand yet she stumbled and fell. I was shocked and thought: 'I am with her and she falls, oh God!' I blamed myself for my helplessness; in that situation I could do nothing. Generally I am sentimental and cry easily, especially when it concerns my family." |
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| Once again we observe his sensitivity to unbearable pain, his daughter's and mother's suffering and his helplessness and inability to get the situation under control. | |
| Dr.: "Were there any other experiences that had a deep effect on you?" | |
| Pt.: "Once I had a severe scalp injury, it was very painful. Another time I ripped my skin and the flesh was exposed, but I did not cry. The pain was unbearable, but I controlled myself and did not feel helpless." | |
| Dr.: "Tell me something about your stammer?" | |
| Pt.: "I have had it since childhood. I always felt very uncomfortable about it and wondered what was wrong with me compared to others; therefore I withdrew from people, only spoke to them on the phone or left the house when visitors came. After my marriage I developed more self-confidence and began to speak in public; I met friends, took part in group discussions and joined workgroups. Even when I stammered I no longer felt bad, and I no longer have anxieties." | |
| Dr.: "What interests and hobbies do you have?" | |
Pt.: "I like outdoor games such as cricket, where I prefer to take an active role in the game or sport – one should play with all one's heart, one hundred percent. You feel enormously happy when you win, proud of yourself and full of vigour. That thrills me! I love music, I like melodious songs, sad old songs, not the cheerful ones. Often I turn the lights off, go to bed and leave the music on; then I become very calm. It sounds so heavenly refreshing, and I forget everything and become calm, even when I have pain." |
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| DR.: "What is the opposite of 'peace and quiet'?" | |
| Pt.: "I never confront anyone, I let everyone be as they are. I feel bad when someone hurts me, makes fun of me or deceives me, but I let it be." | |
| DR.: "Do you value order?" | |
| Pt.: "Yes. I place great importance on things being in their place. I scold my daughter because she is untidy." | |
Analysis: On the one hand we see his sensitivity to his intense, unbearable, severe pain and his suffering. On the other hand we see peace, stillness, absolute quiet and no pain. The problem here is the sensitivity to a feeling: unbearable pain. We do not find the themes of structure, worry and lack etc. that characterise the mineral kingdom, nor is there the persecutor/victim theme that dominates the animal kingdom. This is a pure theme of the plant kingdom. Such a sensitive person, who cries so easily, fits the plant kingdom. Given his sensitivity to unbearable pain, a remedy from the Papaveraceae family is indicated. Remedies of the Papaveraceae family show the following symptoms:
We see that the fear — and the pain — are very intense, leading to cramps, numbness, drowsiness and anaesthesia, and that the person cannot allow their pain and the feelings that touch it, because painlessness is one of the principal symptoms of opium and other members of the Papaveraceae family. On the one hand we have severe pain on the physical and mental level (shock, fear, fright from accidents, injuries, murder, violence, stabbing) together with drowsiness, coma, catalepsy, paralysis and numbness as a passive reaction to the pain. This is the life-feeling of the Papaveraceae: intense, hellish pain, inner turmoil, restlessness. On the other hand, in contrast to the intense pain, there is a state of painlessness, silence and calm, a state like that experienced in meditation, the state our patient describes when he listens to music in the dark and forgets his pain. Miasm: Cancer (control behaviour) |
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| Remedy: Opium, whose central theme reads: "To control pain and suffering or to fail to do so." As we know, painlessness is one of the main themes of Opium; the patient does not allow the pain to touch him because he is so sensitive to sensations of pain. Hence meditation and rest are major Opium themes. Chelidonium, Codeinum, Fumaria and Morphinum are other remedies from the same family that share this state. | |
Characteristic rubrics of this case covered by Opium:
Other rubrics:
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| Prescription: Opium 1M, single dose. | |
| 20.09.04: "I had two pain attacks, but they were not as severe. I feel that my complaints will go away, I know they will be cured. I feel fresh and I do not even get tired from physical work. I am no longer depressed or hopeless. Previously I was sad without reason, but not any more." | |
| 01.11.04: "No pain all the time now and my energy is very good. In recent days I have sometimes had minimal pain in my fingers, but no swelling anymore." | |
| 22.11.04: "My mood has completely changed; I get angry about small things, which previously was not my way, because I normally avoid confrontation. Over the last two days I have felt better and in general I am well; I have no more joint pain." | |
| His anger is a very good sign; in the past he controlled his emotions, now he lets them out. | |
| "I had a dream: I went out with a few friends, I think we went swimming and I thought I could not swim, but then I heard a voice saying to me: 'Go on, you can do it!' So I began to swim and reached the shore. I feel that my behaviour has completely changed. I do not care what people think of me, that was different before. I always betrayed myself and my wishes, but now I decide what I want and what I do not want. I want to keep control of my life. I like these changes in me. My self-confidence has grown." | |
| In the following months his improvement made further progress. Opium 1M was repeated because of a persistent dry cough and sore throat, worse on swallowing and laughing, and also soft stools. A further repeat dose was given. | |
| Opium was given after a two-day fast during a pilgrimage without food and water. He developed indigestion and upper abdominal pain, worse on touch. He dreamt he was trying to finish his pilgrimage, but the thought of not reaching the destination made him restless. | |
| His energy remains good, and he no longer feels tired in the evenings. The joint pains have gradually disappeared completely after recurring from time to time. His mood continues to improve: "Previously there were many problems in my life: my finances, my health, my family, but now I think positively. If something happens, what's the point of worrying and rehashing it. In the past I would get upset and become angry when someone made any remark and think: 'I'll do this or that to him!' and so it went on. Now I think: 'Let them talk, whatever they want.'" | |
| His irritability towards his daughter has lessened and he has more fun with her, instead of getting upset that she is untidy. He no longer doubts that he will achieve his projects, and no longer feels that they lie beyond his reach. "I used to be tense about the future, I did not know how I would cope with everything, but now I am much more confident." His stammer has decreased and he hardly notices it when it does occur. | |
| 03.12.05: "I feel good, fresh and enthusiastic. I have hardly any joint pain and no more heartburn. Previously I was constantly occupied with worrying thoughts, so I could not devote enough attention to my business and my family, but now I have moved away from that and I am so happy, as if I had won the lottery! My self-confidence has improved and I feel at peace. I know that if something happens I can face it. I am carefree, I dance in the streets when the music plays and I do not care what others think. I am satisfied with myself. Previously I lived only for my work and my home and never took part in religious life or social activities, but now I feel that I want to do something for others. There is no point in living only for oneself. I want to be there for my family, but also for other people." | |
Further development: He continues to improve. Although he occasionally has pain in the finger joints, it is much less intense and stops after one or two days without any medical intervention. He still stammers a little, but much less. The change in behaviour has opened up a completely new side of his personality that he did not know he had, and this awareness has suffused his life with a sense of joy and contentment. He is still a very sensitive person, but now his sensitivity no longer limits his potential and no longer colours his perception negatively as before. |
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| A final encounter with the patient showed that there were no signs of the previous crippling pains and that he had stopped all medications. | |
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