Lost in Her Own Dream World
NATIONAL JOURNAL OF HOMOEOPATHY 1997 Mar / Apr VOL VI NO 2.
Dr N L Tiwari
'Mag-ph

Mr X is a 48 yr. Old Chartered Accountant. He is under out treatment for Migraine, chronic sinusitis, Cx spondylosis for the last 25 yrs and having benefited from our treatment, he brought his 39 yr old wife for the complaint of:
1] Recurrent Aphthae since childhood
2] Tendency to constipation since childhood 

Information obtained from the interview
Recurrent Aphthous ulcers since childhood. Acute for last 15 days with lot of salivation.
She likes spicy and solid food.
Garlic and chillies aggravate the Aphthae.
She has chronic constipation, so much so that at times she did not even pass stool for 3 days; and when she does, it is very hard. In her childhood she suffered from dysentery and worms.
Passed round worms and once it came out from the mouth. 

Past History
H/o fall from the cot when she was nine yrs old, was unconscious for about 3 days. Later she used to get headache and vomiting for sometime. Now better.
Had Typhoid at 15 yrs. H/o motion sickness: traveling by car, bus or train. Now better.
She used to get itching all over the body, intensity has become less but she still gets itching sometime. 

Family History
Mother aged 60 yrs, a house wife, suffering from Diabetes. Father 75 yr, a physician, in good health. She has two brother aged 34 and 25 yr. Suffering from recurrent cold. She has three sisters aged 46, 39 and 30 respectively. Eldest sister suffers from Acidity and Asthma, other two have no major complaints. 

Physical General
She looks younger than her age. She is well dressed, fair, average build, with brown hair, brown eyes, red thin lips and. Husband looks much older, is balding, stocky and bony.
Thermals : She is a chilly patient and can not tolerate sun or extreme of weather.
Menstrual History : Offensive and stains fast. Cycle 26 days.
Obstetric History : 12 yr old boy, FTND, born after 8 yrs of marriage.
A significant event occurred during the interview when she was asked about sleep and dreams. She answered " Doctor lot of dreams, various types: like premonition of illness, parties and rest. In the party I am drinking, hate myself for that: also of flying, someone chasing me. I am afraid and running to escape: Failing my examinations: Accidents: Wars, pursuit, fire nightmare³, driving car and my son falling off."
Sleep - Talking, teeth grinding³
Husband who was sitting beside her, just starred at her with surprised look. When the wife stopped narrating her dreams, he looked at us and said, " Doctor in our 20 yrs of married life, she never told me all these things.
The patient, who was lost in her own world, was unaware of her husband sitting near her when she was narrating the dreams. She looked at her husband's little smile and looked quickly away, avoiding any eye contact with the husband. 

Life History Of The Patient
As a child she was close to her father. She was a fair, delicate, loveable child, but quite thin. One elder sister, two younger brothers and two younger sisters. As a child she was sensitive, shy and reserved. She passed XII in commerce and joined Mr X's company for articleship. They fell in love and decided to marry. Their courtship lasted for a long time 3 yrs. Both being students of Economics, they decided to establish in professional lives before having a child.
She was helping him in maintaining the accounts. They could find the time to go on holiday only after 8 yrs of married life. They went to Shimla where she conceived. Their only son is 12 yr. Old after that they decided to have no more children.
At in-laws, she has a 76 yr old mother-in-law, two brother-in-laws, one sister-in-law with no major illness.
Husband is short tempered but loving. He loses his temper in the office if things are not in order. He is a perfectionist and services his clients efficiently. In the office, treats his wife like any other employee. Initially she used to feel bad but never expressed her feelings as she felt he would get hurt. Whenever he loses his temper or gets hurt, he has an attack of Migraine, therefore she avoids hurting him. 

Case Discussion In this case there are two salient features which permit us to know the world of the patient:
1] Spectrum of dreams
2] Husband - wife relationship.

SPECTRUM OF DREAMS: Dreams reflect the subconscious state of the mind. Dreams give us an idea about the inner world of the patient which has to be correlated with life situation of the patient. In patients life situation most important is the husband-wife relationship. HUSBAND-WIFE RELATIONSHIP: The patient has fallen in love at a very tender age of 15/16, which is called the age of the dream world. She got married at age of 19 yr. She has to wait for 8 yrs to be a mother. She could not communicate her feelings to her husband. Her world and her feelings have remained with her for last 20 yrs of married life. Husband even though he lover her and takes care of her, does not know her! It was for the first time husband came to know about her feelings and her world. During the interview he got the shock of his life how little he knew his wife. Husband said, 'Doctor she is possessive at both ends.'
[Indicative that she has not communicated to him about her dream [feeling world] and she has not passed stool for three days.] 

Criteria For Selection Of Remedy
1] Characteristic dreams
2] Menses staining, fast, offensive
3] Chilly patient 

Remedies : Mag-carb, Mag-mur, Mag-phos, and other remedies which came for consideration:
1] Chilly patient
2] Menses stain fast offensive
3] Constipation
4] Motion sickness - Sepia, Silicea
Chilly patient
Fair, delicate, shy
Affectionate Phos 

The final choice was Mag-phos, taking in account both Mental and Physical disposition as already described.
Mag-carb, Mag-mur, Sepia, Silicea were ruled out on the basic mental disposition that is to remain in her own world keeping within herself: anxiety, insecurity and conflict which was not made available to outside world, even to her husband. 
Her affectionate nature and delicate physical structure leads towards Phos.
Mag-phos was thus selected. 

Treatment : Mag-phos 200 to Mag-phos 10M in frequent doses
She has been cured of her aphthae, constipation and dreams.

Conclusion
1] Perceiving the remedy in practice demands knowledge of the physician as stated in Aphorism [3]. Mag-phos is not a well proved remedy. It is mostly used as antispasmodic remedy but if we analyze and integrate our clinical experiences we can enrich our Materia Medica.
2] Study of chronic case should take into account Aphorism [5,6] of the Organon. That is we must investigate family situation, work situation, social situation, moral and interactual characteristics and sex life to understand the person.
3] Once we understand the patient in his/her evolution then only we can create a portrait of the patient.
4] We have to match portrait of the patient to portrait of remedy. Magnesium patients love remains deep down, becomes available only when there is secured environment. Love, hate, anger, sadness etc all that remain bottled up inside, in spite of intensive turmoil. Magnesium manages to have smile on the face. Dream girl lost in her own world.