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Over the past years I have integrated Dinesh Chauhan’s anamnesis technique (a special method of case-taking) into my practice. From my point of view it is a complete procedure in which everything takes place within a cyclical pattern; it begins with the patient’s presentation of the case and ends with the same theme. Every aspect of this anamnesis technique can be explained scientifically step by step and precisely transferred to other cases.
Here I present a case from my clinic showing the conduct of the three stages of the anamnesis technique (Passive, Active and Active-Active).
D = Doctor, P = Patient, HG = Hand gesture
A seven-year-old boy consulted me in February 2009 for recurrent tonsillitis.
Passive case-taking:
D: What’s the matter with you?
P: My nose is blocked, it’s like pinched shut. (HG: he pinches his thumb with his ring finger and second finger). It’s like pressed together. My nose is blocked and something is stuck in my nose, it’s a sticky feeling. It feels as if my nose is full right up to the top. When my nose is blocked I breathe through my mouth. My mother says I must not breathe through my mouth, otherwise my teeth would stick out.
D: Your teeth might stick out?
P: Yes. That looks awful. People say: “Look how his teeth look... Yuck... Ew! Then I have to wear braces so they become straight again. We have someone in my father’s office. He has teeth like that.” (The patient shows a particular facial expression.)
D: So, what’s the problem?
P: Sometimes it hurts. And it looks dirty. It looks hideous, like a dustbin... filthy.
(He describes his problem in a peculiar way. He says when he has a cold he cannot breathe, because otherwise his teeth would stick out, and he looks awful, like a dustbin.)
D: I don’t understand that, tell me more about it.
P: Everything that’s dirty is there in the dustbin. There are banana skins in it, broken lamps, cameras and lots of dirty things. Food that you can no longer eat is in the dustbin. There is a dustbin on our playground, there are many dirty things in it. A bad smell comes from this dustbin.
D: What else do people say to you? Tell me more ...
P: They will say my teeth stick out... it looks hideous... my teeth are zig-zag. I should replace them with artificial teeth, then people would say they look good. Then I will feel good. I don’t want to feel dirty like a dustbin. I want to be beautiful. Beautiful things are beautiful. Good and beautiful!
D: What do you think about that?
P: Me and the whole universe are good. We live on the Earth which belongs to the universe. The Earth and I are both good and beautiful. The Earth is wonderful. Sometimes beings from other planets come and cause problems on Earth. They destroy the Earth.
D: Oh, really? Tell me more about that ...
P: There are evil beings who are happy when they can make trouble on Earth, and there are good beings who do not trouble the Earth. When evil beings come to Earth, then the Earth must fight. Because the bad beings win if the Earth does not fight. They destroy the Earth. When bad beings come to fight, we should show them all the power we have. Even if they come to fight, we will win. We must not lose. If we lose, our country will perish. People from the other country will throw dirt on our land. They will make our country into a dustbin.
D: I don’t understand this. Can you explain it to me?
P: The other country wins and burns our flag. They will make our country into a dustbin and kill all the people in the country. All people will die. Our country will be destroyed. It will be like a dustbin. With a sword they will kill everyone.
(From the nose, the story moves to “beautiful and good”. Then he continues: ... “Me and the Earth are good. But people from other planets come and fight. They want to make our country into a dustbin.” Over the course of his description the image “like a dustbin” appears as a common factor! That seems to be the focus of the case, because it has arisen in various unrelated areas. Therefore I will work actively from this focus.) |
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Active case-taking:
D: You’re talking about a dustbin... can you explain that to me?
P: Dustbin means something bad. Rubbish! Dustbin means that someone throws banana skins and broken things over the whole country, and people die from the smell. The whole country and the whole world die.
D: Tell me more about this “dustbin”!
P: It destroys everything. The Earth will be ruined.
D: The Earth will perish?
P: The Earth and our country will be destroyed. Everywhere in the country lava flows. It will be like a volcanic eruption... and everything is destroyed. Rubble everywhere, everything destroyed. The lava comes and kills everyone. The whole country dies. If a bomb is dropped on the country, it destroys everything and kills all people. The lava comes out because the earth cracks open and everything burns.
D: What do you mean by “Someone drops a bomb and the earth cracks open”?
P: The enemy drops a small bomb that explodes and the pieces fly over the whole country and therefore the earth cracks open.
D: So, what happens as a result?
P: No one will survive. The whole country will be destroyed. All houses and trees are destroyed and nothing will be left. The bomb breaks the earth open and lava comes out. It burns everything and we can no longer breathe.
D: What does “I cannot breathe” mean?
P: Because the nose is like this (HG: he shows the same pinching gesture.) The nose sticks together, and I cannot breathe. I will suffocate. The lava is very hot and turns everything to ashes. All houses burn, all trees burn, all animals and all people die. Only America does not die, because it throws the bomb.
D: Tell me a little more about this “destruction”.
P: Look, I’ll show you. |
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Active-active case-taking:
(The patient is now speaking while drawing.)
P: This here is the Earth, and this is India... this is Pakistan... and this is Russia... Now the bomb comes and cracks the earth open, and the lava comes out, and this cheetah runs away, but he is killed as well, and these houses and trees are destroyed.
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| (The patient makes two further drawings. His description of the drawings shows the same themes of destruction by a bomb). |
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D: So, tell me about this bomb!
P: Evil people throw this bomb and it causes an earthquake. The bomb is very small, but when it explodes it destroys everything. The whole country!
(The boy had finished what he had to say, so I called his mother. I had not yet obtained all the important information about her pregnancy. However she said |
something very peculiar about the patient.)
M: When he was very small he always played a game — he put all his toys in a big bag and tied it up. Then he climbed on the table and said: “This bag is a big bomb!” and let it fall to the floor and said: “Everything is gone, everything is gone!” |
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Case understanding:
In the passive phase of case-taking the patient describes his blocked nose and ends with the words that his teeth look like a dustbin. He then moves into his fantasy where dirty things are thrown over our country, where there is great destruction, and finally the country looks like a dustbin. The transformation into a dustbin is a particular expression |
| that is repeated in two different areas. When I consider the “dustbin” as the focus, I become active by understanding his perception of being “like a dustbin”. We recognise that from the dustbin the description of destruction, murder, the end of the world, the destruction of the Earth, attack by enemies, destruction by a bomb, lava, earthquakes etc. emanates. So he moves from dustbin to annihilation. |
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Additionally, he links his main complaint, his inability to breathe, with a similar gesture (pinching his nose with his hand) as the one he uses to describe the effect of bomb destruction and lava eruption. His inability to breathe (which he expresses with his hand gestures) in colds as well as during destruction is one and the same. This confirms to me that I am on the right track and that understanding the “destruction” will lead me to the patient’s core experience. Therefore I move to Active-Active at this point.
In this final phase of case-taking he describes by his drawings how this destruction is caused by a bomb that kills everyone; no one is left alive and everything is destroyed, including people, plants, animals and the Earth itself. The bomb explodes and destroys everything. This is the centre of the case.
Interestingly his mother confirms this when she describes a game he always played as a small child: he played that he threw a bomb and with his toys caused mass destruction.
In this case the description of total destruction of a structure points to the mineral kingdom.
Series 7: Mass destruction by a bomb that destroys the whole country, including people, trees, houses and animals.
Prescription: Uranium nitricum 1M (The patient is on the level of delusion).
Uranium nitricum, proving by Dr. Sujit Chatterjee:
Dreams / delusions of explosions, war, death, dying
Follow-ups:
March 2009:
M: He is doing well. He had no attack this month and sleeps peacefully, without snoring — previously he snored a lot. The nose seems to be clear, no longer blocked.
Treatment plan: Placebo.
May 2009:
P: I had a small cold with green discharge, but no fever! In the last two months I have been well. I only had fever once, but your remedy (Uranium nitricum) helped me.
M: He recovered after one day. He did not need anti-inflammatory medicines. He now has more energy and does his homework on time. He swims daily and will even participate in a competition.
Placebo
August 2009 (phone call):
M: He is doing very well. He has had no tonsillitis in the last six months. That is a remarkable achievement. We have not been to the paediatrician for a long time. He has become much more attentive. His appetite has increased. He acts more consciously. He no longer breaks his toys!
Placebo
December 2010:
P: Doctor, I had a dream. I saw a bright light, and God appeared to me in the dream. He said: “I have commanded all people to stop fighting, and to stop doing bad things like weapons and bombs.” He said there will be no more war!
Interestingly I found the following rubric in the Uranium nitricum proving by Dr. Chatterjee: Dreams of God, hears God’s voice.
The child is continually improving, and he only comes to see me now when he has a cold. |
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