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Case Study

I must do my duty
Dr Gajanan Dhanipkar

Mr V M 35 yrs Maharashtrian male came to me, on 10th July 03, with Chief Complaint of eruptions with itching since one year.

Chronic urticaria. Starts as a wheal on face, hands and hips and increases as the day progresses. Associated with itching.

Modalities: < Channa dal items, < Fried food, < Fish.

Associated Complaints: Burning in chest Pain epigastric region. Occasionally complaints of frontal headache. < Non-veg, < Spicy, < Sleeplessness.

Personal History
Appetite: Good.
Desires: Chicken3, Spicy, Mangoes.
Thirst: Increased, 2 to 3 liters/day.
Stool: Normal
Urine: Normal
Sweat: Profuse on scalp especially in sleep.
Sleep: Normal.
Thermals: Chilly patient

Past History: Typhoid and Jaundice.
Family History: Fa: Asthma, IHD, Mo: Paralysis, DM
Br: 1st Non-healing ulcer, 2nd DM, 3rd DM and epilepsy.

Mental State: The patient started narrating his complaint by stating that, as the eruptions and itching increase, he starts becoming uneasy, must stop. Because of this I cannot work, I get bored and I loose my concentration. I have responsibilities at my office. When I am not able to clear my file work, I feel like I am committing mistake. If I am not performing my part, not doing my job properly, I have lots of work pressure.'

He also gave an incident in his daily life where he was supposed to clear some land papers of his sister's flat. He always kept on postponing this and his sister kept reminding him of the same. When asked what he felt when she reminds him again then gain he said, 'I feel I do it purposely...everything should happen on time and it is not being done, I feel I am not performing my duty, my job. Its like I am committing mistake, not performing on my part, not doing my job properly... recently I have noticed that the amount of work I do now is much less than I used to do previously.'

2nd incident: He said, 'I was once given a task of checking some Rate files of our new R and D department. I was not able to give it on time and I had to tell them that I will submit my file next week... at that time I felt pressure on myself.' I feel as if when will I get free. I feel I should come out of this pressure immediately.... Like I have some 'dadpan' on me, and I should come out of it.'

When asked about experiencing such similar pressure he said, 'yes, I felt the same pressure when my wife refused to look after my mother who is paralyzed and cannot move. But I explained it to her that it is my responsibility to look after her and ... latter she agreed for it.'

In further interview he said that he felt uneasy, under pressure, and could not perform the way he could because of his wife not behaving well with his brother, his wife and his mother whereby he is under pressure to maintain his relations between mo, his brother and his wife.

He further said "... I feel very bad. I have to look after my wife and elder brother, it is my duty to do so. I should have balance on both sides. Doctor when everything will go well my pressure will get reduced.

Dreams: Of quarrels or fights at home which puts him in lot of stress or pressures.

Understanding of the Case
In this method, we understand the patient by perceiving the chief complaint and not by interpreting him in his problem till we get the area of sensitivity, which is affected because of the chief complaint. Then based on his reaction to it we classify it in to kingdom: mineral, plant, and animal, and than further to sub-classes and come to the remedy.

Here if you understand, the chief complaint affects the patient's sensitivity to work properly, we see his perseverance in his work, his duty conscious nature, his desire to perform to his best of his abilities. Having routines and discipline is what he prefers but due to this problem he is not able to work properly.

His performance, his ability to work, his concentration in his work is affected. His mother's responsibility is like a duty to be taken care of, all brothers do every three months in cycle but when it comes to him it is pressure situation to him because of his wife.

For him there is an important issue to achieve a balance between the job, his relations, his wife which is his responsibility.

His chief complaint is urticaria. And the main emotions due to urticaria is irritability, loss of concentration in his job, due to which he has lot of work pressure So we cross the level of Name, Fact and come to the level of delusions that he is under pressure But, in that he is not able to associate any Sensation. He just talks of emotion ie irritability and anger.

This pressure is very intense and is based on delusion of having responsibility and conscientiousness of his duty to perform.

What is the Delusion?
Being under pressure due to work in office and the situation in the family. He feels better in secure place with his brother, his mother and his whole family if it is well taken care of.

When asked to describe the pressure in terms of sensation, he is unable to take us to any one sensation that is consistent in the case, but that feeling of pressure does not give any experience of any reaction or nervous excitability or sensitivity seen. It is not a plant sensitivity or a case of animal issue of survival or hierarchy.

Behind these delusions- and the life situation what we get is that he lacks something in himself in terms of being under pressure in the perspective of work, performance and family. The sensation is not in term of a plant sensitivity but in terms of his basic feeling of lack of security and structure. When this goes away then there is Extreme fastidiousness of performing, being perfect, and doing his duty properly at office, at home as a husband, brother and a son which puts him under pressure.

This is the issue of a Mineral Remedy: Lacks a Structure
The pressure experienced is not specific, but the need is very specific.
Level 1 Name
Level 2 Fact
Level 3 Feelings
Irritability and anger
Level 4 Delusion
Being under pressure, in situation of work in office and in his house.
Dreams: Feeling of being in pressure in dreams of family quarrels seen by him.
Level 5 Sensation
Leads us to Mineral Kingdom

Which Row?
 Security, dependence

Rows and Columns
Rows and issues

  1. Hydrogen Existence, birth
  2. Lithium Separation
  3. Natrum Identity
  4. Calcium Security
  5. Strontium Creativity and performance
  6. Barium Responsibility
  7. Radium Disintegration, death.

Homoeopathy and elements- Jan Scholten.

Column 8
No issue of foundation.
Perseverance, persist with it in spite of force or opposition.
Resistance. Determination. Strong will.
I have to go against resistance, pressure, opposition and I have to stand firm. I am complete, I've been careful and cautious I will not submit to your pressure.

Stage 8
The central theme of the Ferrum series is the individual task, the strong drive to work hard is well known in Calcarea They feel very responsible and want to fulfill their tasks as best they can.

Heavy Pressure
The task is not a task, it is also a duty. The task is big and the pressure weighs heavily on them. The happenings in the family and in the house are often felt as burden.

Remedy Given: Ferrum-met 200 single dose.

Follow Up
17th July 2003 Patient was better. No urticarial rash. SL was given.
18th August 2003 Urticarial rash was noticed Occasional heart burn and acidity Single dose with SL was given.
17th September 2003 Patient better, Rash had disappeared. SL was given.
20th Oct 2003 Patient was 60% better. No complaint of heart burn. SL was given
24th December 2003 Patient better. No rash. SL was given.
6th January 2004 Patient complained of an acute episode, No complaint of acidity single dose of Ferrum met 200 was repeated.

Patient is better since then, till date.