A Synergistic case study: from Symptom to System

This is a case of a 44-year-old lady, who first consulted us in March, 2013 with multiple complaints. She complained of pain in her lower limbs extending from the knees to the ankles. There was severe pain in the ankles, which would be aggravated by air-conditioning draft, and her extremities would turn cold. She also complains of frequent headaches. She experiences a lot of weakness, especially in the evenings. Over the last few days, she has bloating of the abdomen, due to gas formation, which causes considerable discomfort. She gets episodes of low blood pressure, with a feeling as if nothing is left in the body. She gets cold hands and feet, with an experience of restlessness, with sweat on the forehead. She gets sweaty palms. She has a lot of pain in her back, which is worse on rising from a sitting position. The back feels stiff when sitting for a short time.

By nature, she is a very anxious person and gets restless if she has to go somewhere or has to travel by train. All her complaints are aggravated since she was diagnosed two years ago with polypoidal endocervicitis and endometriosis, when her menopause started. Since then, she feels very restless and sweats profusely. She then went on to describe more about her nature, saying that she gets nervous easily, as she had been a protected child. She was an only child and she never went out anywhere alone. Her fears and anxiety heightened when her father passed away a year ago. When talking about her father, she started weeping and said that her father was everything to her. He would take care of her and she did not have to worry about anything while he was alive. She was very attached to her father and had been very anxious about his health. She used to share all her anxieties and worries with him, everything regarding health, family, job, career, finance and children. To her, he was a guide, someone who gave good advice and support. He was so caring that he would arrange things even before she asked for help, such as paying for the children’s school fees. She depended heavily on him and would be very restless if she would not speak to him for even a day.  She felt that she could not live without her parents. she felt very alone after his sudden demise.

With the passing of her father all the responsibilities fell onto her. She had to look after her mother and even her husband was hospitalized soon after. After his death, she became very stressed since she never did anything alone or made any decisions on her own: she would feel restless and lonely, and would end up weeping if she had to make decisions. At such times, she felt uncared for and alone in his absence. With this, she experienced weakness in her extremities and broke out in a cold sweat. She then experienced headache and chest pain.

She was very anxious about herself and her family. She constantly feared that something would happen to herself or her family members. She felt that her blood pressure may drop and that she would not be able to work. All her family members are dependent on her; they all need her to help them with their work, right from their routine to their work and studies, and she has to constantly advise them. She says that her family simply cannot do without her, so much so that her mother-in-law feels helpless in her absence and starts weeping. She is very caring and cannot see anyone in a bad state; she does her best to help them out.

Trifles make her anxious. She is anxious about her daughter’s examination, her son’s admission, if she is to go out somewhere, if she has to catch a train etc. The anxiety brings on weakness and headache with tinnitus. Headache is mainly in the supraorbital region and it feels as if she is being hammered from the inside, it feels to her as if her head would burst. The pain is better from sleeping, drinking tea and fanning. As a child, she was very afraid of many things. She was very afraid of the dark and she would not go anywhere alone; she always needed someone with her. She was very afraid to hear stories of ghosts and hence feared the dark, fearing that a ghost would harm her. She desires sweets and spicy food. Her menses are offensive. She has recurrent dreams of examination and feels that she is not able to complete the paper, feeling that she was missing something crucial.

Analysis

If we see the prominent symptoms of the case, we see that there are some symptoms that run throughout the case, as well as some very specific local symptoms. We see that she has pains which are aggravated by drafts of air. The main causative modality, as she clearly states, is since her menses were about to cease. She has a lot of weakness which is worse in the evening, and backache which is worse on sitting. There are some symptoms which form a part of her state, namely, coldness of hands, perspiration of forehead, and headache which was worse from emotional excitement.

Along with this we see some characteristic mental symptoms: fear of darkness, fear of being alone, dreams of unsuccessful efforts. Other characteristic symptoms at a general level are desire for sweets and offensive menses.

When we combine these symptoms, we form a totality which describes the patient as a person. From this totality, we see that a few remedies stand out prominently, among which Kali-carb covers all rubrics in the highest grade.

In looking at the system as a whole, we see that the main thing for the patient is dependence and feeling lonely without the support of her father. She needs the guidance of her father for routine things like health, money, kids, and job. She is very timid; she has no courage to face the world and always needs the opinion of her father. When faced alone with situations, she often breaks down and cries. This dependence and the need for support are indicative of a Mineral remedy. This complete dependence on someone, with indecisiveness, is indicative of column 1 of the periodic table. On the one hand, we see that she is dependent on her father for small routine things and on the other, that her family is also dependent on her for small things. The issues pertaining to routine, like health, finance, work, health, and education show that she needs a remedy from Row 4.

The remedy Kalium carbonicum corresponds to Row 4, column 1. This approach, where the system and the symptoms come together to give definite, sure results is called Synergy. The references confirm Kalium carbonicum as the indicated remedy.

Soul of Remedies – Kali carb

Kalium carbonicum belongs to the sycotic miasm. The main theme of Kalium carbonicum is the vital fear and reactivity (Carbon) that is seen when a person lacks the support of a family or group (Kali).

The main symptom of Kali carbonicum is the fear of being alone and the desire for company. In the Kali carbonicum woman, there is tremendous anxiety and fear when she is alone. She seeks to belong to a group/family so that she is never alone. This anxiety is seen everywhere. For example:

           o Frightened at trifles

           o Fear of being alone

           o Startled easily, from noise, from touch

           o Dreams of ghosts, of danger, of robbers, of falling from a height, of frightful figures

There is a strong desire for support which is seen in:

           o Carried, desires to be

Her dependence on the group or family is so great that her entire life revolves around her family: the health of family members, the integrity of her family, the amount of support she gets from her family, etc.

 She becomes anxious if her child falls sick or doesn't do well in exams, and she can become irritable and impatient with him. Similarly, when she feels that her husband is not supporting her enough, she becomes irritable, quarrelsome and nagging, which is expressed as "Shrieking at trifles" in the rubrics.

Prescription: Kalium carbonicum 200C, 3 doses. The potency selection was 200C as the patient was at the level of emotion, where a lot of emotional factors aggravated her physical state.

Follow-up

The progress that followed within two months of treatment was very encouraging. A year after starting the remedy, the patient was much better. She said that she was very happy and small things no longer caused in her stress like in the past. She was calmer and more independent. Her weakness was markedly better. Back pain was almost ameliorated by 60%: she had intermittent joint pains but they no longer caused her major suffering. Her anxiety was much better and she felt quite energized due to the results. After a year, she said that all her complaints were almost 80% better.

The system and the symptom combine to give definite results which are reproducible. What needs to be adopted is an approach which is most applicable to a case. In the above case, the symptoms were very obvious, so each one was explored in detail and specificity. These symptoms were put together in a totality, which yielded only a few remedies. When backed up by the system, the sensation approach gave a confirmation about the remedy indication for the cases and the results that followed were remarkable.

Case written and edited by Sneha Vyas