I'm frightened of being injured: a case of Arnica

A fifteen year old boy came, accompanied by his grandmother, for the complaint of nocturnal enuresis. I was bit surprised, wondering how this boy and his parents must be managing this problem. Adolescence is a dreamy time of life, when everybody wants to fly freely in the sky. The enuresis must be having a deep impact on this boy.

His grandmother started the conversation saying that he never gained control of his urine at night. He wets the bed almost every night, sometimes even twice. I asked his grandmother to sit outside and I started talking with him. Initially, I decided to give him space, asking him to tell something about himself, but he did not talk at all and made no eye contact. He just sat with his head down, picking at his nails. Finally, after trying everything to open him up, I started to ask him direct questions.  

Shardul Joshi (SJ): What impact does this situation have on you?

Patient (P): I feel embarrassed whenever I visit my relatives. I feel uncomfortable and I am ashamed of myself. People point at me. I wish that this bed wetting would stop forever.

SJ: Tell me more about this feeling of embarrassment and shame?

He was not able to talk about this, so I asked him about his dreams.

SJ: Tell me about your dreams?
P: I am playing football at school. The ball hit my friend’s eye and his eye became black and blue due to the injury. The doctor told us that it is a severe injury, which has damaged the eye internally.

SJ: What was your experience in that dream?
 P: I got frightened and I woke up startled. At night, if there is a loud noise I wake up startled, with, palpitations and trembling. I get frightened and wonder what has happened.

SJ: Tell me more about your dreams?
P: Once, a coal machine fell on a man and broke his leg. I got frightened in the dream. What would that man have suffered? How much injury and pain he must be having?

I am afraid that a ghost will come. If I close my eyes, I see a face in front of me and then, I am startled and shivering.

SJ: Tell me more about what you see?
P: It is a whitish face like an ox; it is blurred - not clear. I see trees around me. The face rushes towards me as if it wants to kill me. I get up startled and trembling with fear.

SJ: Tell me more about that fear?
P: It will come to my home and kill me. I feel that he is stabbing its horns in my face.

SJ: Any more dreams?
P: There is some legal issue going on in court; my uncle was an inspector and he was there in court. Someone came with a large stick and started hitting my father. My uncle comes in between the two and he beats that person. 

SJ: Tell me about your fears?
P: In school, I am afraid of my teacher. If I do not complete my homework or if I miss school then my teacher beats me. He sends me back home and asks my parents to give me a note for missing school.

SJ: Any other fears? 
P: I am afraid of my father, too. If I don’t sit in the shop, my father will scold me or beat me. I feel that I should help my father in the shop since he does a lot of hard work.

SJ: Tell me more about your fears?
P: I am afraid of the dark because I cannot see anything; I might fall in a pothole. I get scared that somebody will come and kill me or that some ghost or spirit will come and attack me or kill me.

SJ: Tell me about your childhood?
P: In my childhood, we had a sweet making business at home. I use to steal sweets and my grandfather use to beat me for that. In childhood, I was afraid of the dark. Once, my mother locked me in a dark room for two or three hours. I was afraid that somebody would come to harm me or kill me. After that incident, I fell sick and had a high fever.

SJ. Tell me about your hobbies.
P: I like watching TV and comedy movies. I love playing cricket.

Observations by his grandmother
“He is irritable by nature. He does not talk much and he does not listen to his parents. He only answers as much as we ask him. He loves to play a lot. If there is a power cut with the lights off, he sits up suddenly and starts crying.”

Patient’s history: “Once, I fell from a tree. I got bruises and a swollen knee.” Appendicitis.

Family history: nothing significant

Physical generals
Appearance: average built with pale complexion
Facial acne with scars
Big nose
Appetite: good
Thirst: 7-8 glasses / day
Perspiration: palms, medium.
Pungent Bowel / Bladder
Regular Sleep: position on back. Startles during sleep
Temperature: on the warm side

General examination
Palms – Moist
Tongue: centrally cracked and slightly white coated

Case analysis
He has various fears: ghosts, darkness, getting injured, being attacked by an ox, etc. When we look at the different areas of his life, one theme runs through the whole case: injury. He is very sensitive to becoming injured and his reaction is sudden startling, trembling and palpitation. This sensitivity leads us to the Plant kingdom. His 'fear of getting injured' is the centre of the case and his reaction is sudden. I thought of the Composite family and the Acute miasm*. I searched rubric 'Fear of getting injured'. In the Complete repertory, there are 19 remedies, including Arnica.

Prescription: Arnica 200C one dose (22 November 2012)

Follow-ups

After one month: started feeling refreshed. The frequency of fearful dreams is reduced. Appetite and sleep are good. The frequency of enuresis is drastically reduced: he has only wet the bed twice during the whole month.

Prescription: Sac lac continued for one month

After four months: enuresis has almost stopped; he has only wet the bed once per month or less. He feels more confident and has no more fearful dreams.

Prescription: Sac lac continued for one month

After six months: the enuresis is completely over; he has had no bedwetting during the last two months. His parents report that his fears have reduced and he has no more fearful dreams. He is more confident and more communicative. Now, he can spend the night out with his friends or go to his relatives without any shame.

Prescription: Sac lac for one more month. I asked him to stop the medicines after that and to report to me after three months. His parents called me after a few months to tell me that he has completely stopped wetting the bed and is leading his life confidently.

*Rajan Sankaran. An Insight into Plants, Volumes 1, 2, 3. Homeopathic Medical Publishers, Mumbai, India

Photo: Wikimedia Commons
Arnica flower; Aimaras; CC BY-SA 3.0