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CASES MATERIA MEDICA GENERAL ARTICLES ABSTRACT MISCELLANEOUS Q & A

Case 66: He presented with heel pain but had loathing for life
NATIONAL JOURNAL OF HOMOEOPATHY 2006
Dr RUCHI JAIN, MD Part I and Dr Anand Kapse MD Hom

Abstract:
A wonderful case which teaches each of us how to analyse the case and reach to the causative factor. And the patient who came with a frown on his face after giving the remedy, changes to with a smile on face. The remedy acted so well that along with the pain, the worthless feeling, the suicidal thoughts, desire to be alone have all gone. He was threatening to discontinue treatment in a few days but now promises to bring 4 more patients.

Preliminary Information
Date Of Case Recording: 11.6.08. Mr TDP, 51, Married, Education-10th, Was a fitter for 28 yrs; now has his own poultry. Religion- vanzari Non-vegetarian

Chief Complaint

Location Sensation Modality
Left heel
Since 2001
< since 4 yrs
I-Mod-Severe
F-Daily
D-Continuous
Pricking pain2
No h/o injury
No swelling/ tingling
< Pressure3
< 1st motion
> Rest3
Mind
Since 2004
Worthless feeling3
Suicidal thoughts2
Desires to be alone3
Decreased sexual desire3
Sleep disturbed
A/F- Loss of job3
Ear
Bil since 2 yrs
Occasionally diminished
hearing
No tinnitus
< Winter
< Draft of air

Patient as a Person
Appearance: Average built, whitish complexion, male type baldness
Skin: Cracks on soles every winter, Warts on neck
Perspiration: Moderate. No odor. no staining
Craving: Fish3, sour2, AVERSION- Milk2, curd2
Stool: Once a day, satisfactory
Urine: 4-5 times/day, occasionally in night
Sex: Desire decreased since loss of job
Sun Exposure: Giddiness. THERMAL STATE- C3H2

Family History:: Father - Hemiplegia. Daughter- Renal Calculi

X Ray:: Father - Hemiplegia. Daughter- Renal Calculi

Life Space Investigation
51 yrs old male came to Rheumatology OPD for heel pain. He was born and brought up in a middle class family. Father was a farmer. Patient has 4 elder brothers and 3 sisters; he is youngest. Failed in 10th STD, left studies due to less interest but now regrets it. Other siblings completed their education and secured good position now. Pt worked as a fitter in Zenith chemicals for 28 yrs. He married 23yrs back. Wife is quite irritable, arrogant and dominating He avoids arguing with her. He just comes and gives his salary to her. She looks after all the household affairs. She is well educated and handles all the responsibilities well.

He is always been very industrious and sincere at his work. His job was his passion of life; he enjoyed his work a lot. Had a good friend circle and enjoyed their company. Used to always be the center of attraction amongst his friends. Factory was closed suddenly in 2004 due to losses. Over 300 workers were removed from the job without prior intimation. They all fought for it in the court but got only compensation money. Since then all his complaints have worsened. Feels that his life has ended; now he is just living a bonus for the sake of his responsibilities. Gets frequent suicidal thoughts, has worthless feeling. Wants to stay alone, now sleeps in the farm. Sits alone brooding over the past, even weeps when alone. There were tears in his eyes with smile on his face while narrating the above incidence. Has stopped going to place where factory was there as it reminds him of his golden days. Has no contact with his old friends. Feels ashamed of what people will say as he hardly earns anything. Does not want to be dependant on any one in future; therefore is worried about his health and future. Now he owns his own poultry, which is running well. But still he feels that he does not get the same satisfaction as what he had from his job. Feels that life has come to an end, has stagnated, that life ended in 2004. Felt as if life is a vehicle and petrol has ended now; driver has changed so whatís the use of living such a life.

At home, he feels that attitude of his family members has changed. Now doesnít get the respect what he had.

The decisions are being taken by his wife so whatís his need at home? Since then, he has become restless, irritable. He cannot tolerate least contradiction. Once he takes any decision then itís very difficult to move. He was so much desperate that he told me that if I am not able to give him relief in few days then he would leave the treatment and search for another doctor.

Totality
A/f loss of job, loss of loved object      Chilly patient
Grief   Craves fish3, sour2
Worthless feeling    Aversion- milk2 curd2
Suicidal thoughts    Sun< giddiness
Desires to be alone     Warts on neck
Anticipatory anxiety    Cracks soles in winter
Irritable
Broods over past events
Weeps when alone
Industrious

On Repertorisation Remedies Coming Up Were
Ignatia-7/13, Nat-mur-7/13, Aur-m 7/10, Carc-6/6.

Resolution Given By Supervisor: He should not take life in such a negative way. He might have lost the job but life has not ended here. He has so many things in life to do. Every one in life has some bad events but thatís not the end of life. Happy days do come again. It depends on us how we look at it. Patient assured that even though he harboured suicidal thoughts he would not make any such attempt.

Follow Up

Date Follow Up Action Taken
11.6.08 Case defined. Placebo
14.6.08 Pain 5% better. Worthless feeling still there. Aurum-met 1M 1 PHS
21.6.08 Pain 80% better. Worthless feeling >2 Placebo
02.7.08 Pain 85% better. No worthless feeling. Placebo
09.7.08 Pain 90% better. No worthless feeling.
Started enjoying his work.
Placebo
16.7.08 No pain. No worthlessness. Very much happy. Placebo

My Learning: I learnt a lot from this case as I was thinking and came up with the diagnosis of Calcaneal spur; but X ray showed no positive findings. I did not think that main seat of the disease is mind and not the calcaneum and pain in heel was the somatisation. The final diagnosis of the case was Major Depressive episode.
After discussing the case with observer, I thought of Natrum-mur but after discussion with supervisor and referring to Materia Medica we came to Aurum-met Patient was originally an industrious man who could not digest sudden loss of job and came down with profound depression with feelings of worthlessness and loathing for life. This evolution of the aspects pointed to Aurum.


Case: 67
Osteomyelitis: Myths and reality

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