Abbreviations: MG: Mahesh Gandhi; P: Patient; HG: hand gesture. Cases have been shortened for readability.
Case 1
This case concerns a 45-year-old man who presented to the clinic because of his anxiety disorder. He has suffered from this anxiety disorder with panic attacks for 20 years and is being treated with psychotropic medication. The patient traces his first panic attack back to his final exams in medical school. At that time he had to study 14 to 16 hours a day. He developed palpitations and chest pain, which alarmed him greatly because he thought he had heart problems.
The patient reported situations from his student days in which he was extremely stressed, for example during his placement on the leprosy ward when he was very afraid of becoming infected. Even the simplest procedures, such as a pleural tap in a tuberculosis patient, would trigger trembling and anxiety in him because he feared he might puncture the patient’s lung by mistake. He was also unable to administer vitamin injections because he feared the patient might suffer an anaphylactic shock. His great fears about the supposed dangers of infectious disease medicine eventually led him to become a pathologist, because he thought that would mean less stress and anxiety.
But even as a pathologist he could not really overcome his anxiety. Regularly he would send laboratory results to other laboratories for confirmation to reassure himself and calm his anxieties, even if that meant paying for the tests out of his own pocket. Despite this, he initially hoped to open his own practice after a year, which never happened. He began working in his father’s practice, where, among other things, obese patients were treated with Ayurvedic medicine. That appeared to the patient to be a safe option. However, he still had to fight his fears there. Once, when he treated an overweight patient with a blood pressure of 140/100, he was convinced the man would suffer a heart attack at any moment. He imagined all sorts of worst-case scenarios, became extremely agitated and phoned the patient every five minutes to ask after his condition.
Because this problem runs strongly through the entire case history, I wanted to explore it more deeply to investigate the level of sensation.
MG: What is the worst thing that could happen?
P: “There could be a court case and these proceedings drag on for years. How can I live with that uncertainty for years? I could be imprisoned and would have to be with all the criminals in jail. I would then be sexually assaulted – what if I contract AIDS? Just the thought of it gives me palpitations, my mouth goes dry, I have chest pain and I feel dizzy.”
The patient describes himself as gentle, kind and peace-loving. He is not fond of hard work, but enjoys the comforts of life. He likes flying kites. By nature he is rather a coward, but dreams of beating up the many scoundrels and being cheered by his friends for it. His wife thinks he makes too much fuss about small things and gets too upset about trivialities. For example, once he misplaced his mobile phone and was convinced that criminals would use his phone to order a murder and that he would be imprisoned for it. He constantly worried about being sexually abused in prison and contracting HIV there (at this point he even jumped up from his chair to take a deep breath).
This point in the case history is very important: the patient describes his palpitations and jumps up. We can literally see the anticipatory tension, which is expressed by palpitations and cramps, etc.
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P: “Whenever I travel and can’t move, I don’t feel well. I don’t like being confined. It’s a dilemma: should I go or not?” His restlessness can be understood as an attempt to flee. “Should I go or stay? Whenever I have these symptoms I feel the need to escape. Then I need someone to reassure me. These situations exhaust me.”
He describes another situation in which he became panicked. His daughter was ill and the treating doctor asked him to collect the laboratory results three days later. The idea of having to wait three days for the results was intolerable. The problem for him was not that the results might be bad, but that he would have to wait so long. The anticipatory tension is deadly for him. He develops a feeling of tightness in the chest, palpitations and a sensation of constriction, etc. The patient also reported that he has no problem taking a bus or train as long as he can board immediately. But if he has to wait two days for the bus journey, he can hardly stand it. The waiting exhausts him.
At this point in the case-taking we return to the topic of prison and waiting to see what emerges.
P: “In prison many dangers lurk: I could be attacked by a homosexual and become infected. Court proceedings usually take a very long time. They move very slowly, but I need quick solutions. That would be very stressful for me.” (HG: the hand moves jerkily. The patient takes a deep breath.)
“The uncertainty is very stressful for me. I don’t know what will happen. I am always afraid that something will happen; the legal process overwhelms me completely. I would be entangled in it and it would drive me mad.”
He describes his notion of being “entangled” and speaks in detail about court proceedings that drag on for days during which people are repeatedly called. The slowness of these proceedings would give him sleepless nights and make him very restless.
The patient’s main problem and thus the essence of his personality is uncertainty, which triggers great fears in him. Uncertainty provokes fear, regardless of what the uncertainties are: anaphylactic shock, laboratory results, Ayurvedic herbs or bus journeys. The uncertainty is beyond his control and can extend over days, sometimes seemingly indefinitely. The restriction of movement, the deep inhalation, the springing up from the chair and the jerky hand gestures he experiences in these situations or in his thoughts are characteristic of his nature. These features run through the entire case and become visible both physically and emotionally. The sensation that a patient has fully internalised and which is expressed on very different levels is called the Vital Sensation.
In the present case we can see that the main theme for this patient is rooted in his uncertainty about the future and his fear of future events. In addition there is a fear of illness: he worries that he might become infected and perhaps contract AIDS (Acquired Immune Deficiency Syndrome). By nature he tends towards comfort-seeking. Fundamentally he is a coward who in his imagination beats up other people and boasts of his strength. This fear of the future and fear of illness – particularly of infectious diseases – is a characteristic of Calcium. (Ref: Despair about shattered health, hypochondriacal; despairing mood with fear of sickness and misery, with foreboding of sad events; fear of contagion, fear of loss of mind). [1]
There is another aspect in this case: the sensation of being constricted, confined and entangled. This aspect corresponds to the essential sensation of Nitrogenium. [2]
Nitrogenium belongs to the lithium series (row 2 in the periodic table of the elements/mineral kingdom). The most important theme of the mineral remedies is structure – the innermost core of one’s own structure and the accompanying need to perform all the functions necessary to maintain that structure. This leads either to a lack of or a loss of one’s own abilities required for the respective function. The themes revolve around the question “Am I capable or not?” This question is very clearly represented in the periodic table of the elements, since each series (row) stands for a particular stage in human development. The main themes of the seven rows of the periodic table are as follows:
Row 1: Existence
Row 2: Separation
Row 3: Identity
Row 4: Security and duty
Row 5: Creativity and performance
Row 6: Responsibility
Row 7: Decay [3]
In the lithium series everything is therefore clearly about separation from the mother. From left to right, the lithium series contains the elements: lithium, beryllium, boron, carbon, nitrogen (nitrogenium), oxygen (oxygenium) and fluorine. The remedies of this series correspond to different stages of human development from the time of conception, through the maternal pregnancy, to the entry into the world and the subsequent separation from the mother. Hydrogen (row 1 of the periodic table) corresponds to the stage before conception up to the point when ovum and sperm fuse. The remedies from row 2 thus describe the sensation of adult people who, in their inner experience, still feel as if they are in the womb or in the state of separation from the mother. Each remedy of this row relates to an individual developmental stage. Nitrogenium, for example, is on the right side of the row. People corresponding to this state describe an inner sensation of constriction, of being narrowed, as actually happens during birth when passing through the birth canal. The patient’s sensation corresponds to the birthing process.
In the present case the theme of uncertainty predominates. If you look up the remedy Argentum nitricum in Rajan Sankaran’s “The Soul of Remedies” you will find that these patients cannot tolerate anticipatory tension or excitement. This fear is the characteristic feature of the remedy. The uncertainty cannot be brought under control. This loss of control is a characteristic of the right-hand side of the lithium series.
Thus, on the one hand we recognise the properties of Calcium (fear of contagion and cowardice), on the other hand we have the uncontrollable uncertainty, constriction and entanglement of Nitrogenium on the right-hand side of row 2 of the periodic table. Consequently Calcium nitricum is the appropriate simillimum for the case.
Prescription: Calcium nitricum C200, to avoid an initial aggravation.
Follow-up: Six months later the patient reported that he felt much better and more at peace with himself. The anxiety attacks had significantly decreased. Where previously small things had triggered a panicky reaction, he now responded with calmness. Family and friends had also noticed positive changes. He returned to the clinic because of bloating. A dose of his constitutional remedy resolved this problem as well.
The cases were prepared and compiled by Sneha Vyas and Devang Shah.
Sources:
1 – Michael Hourigan and David Kent Warkentin, ReferenceWorks Pro, 4.2.1.1, Clarke’s Dictionary, Mind
2 – Rajan Sankaran, Structure, Volume 1, Row 2, Nitrogen
3 – Rajan Sankaran, Structure, Volume 1
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Photos: Shutterstock
Green two-way sign;iQoncept
Single soap bubble; PanicAttack
Category: Cases
Keywords: Anxiety disorder, panic attacks, schizophrenia, trauma, catastrophe, convulsions, confusion, hysteria, lithium series, asphyxia, separation.
Remedies: Boron metallicum, Calcium nitricum, Lithium muriaticum, Nitrogenium, Oxygenium
Original article: Interhomeopathy.org
