Something is choking me: a case of Crotalus horridus

A forty-two year old lady came with following complaints: recurrent bleeding hemorrhoids for the last twenty-six years (operated twice, in 1986 and in 2009). Rheumatoid arthritis for the last six years. Vertigo for the last three years
(HG stands for hand gesture)

Greeva Mankad (GM): Tell me about your complaints in your own words.

Patient (P): “My main concern is arthritis and bleeding hemorrhoids. I also have various aches, giddiness and sometimes acidity.

“With the arthritis, my right hand is more affected than the left. It started with my right hand. My right knee also hurts sometimes when I walk for a long time. The finger joints of both the hands are usually swollen in the morning; the swelling comes and goes. They generally swell when I eat something sour or when it is too cold outside. They become so stiff and sore in the mornings that I cannot grasp anything and sometimes I drop things. Then, my hands feel too weak to move, and they tremble sometimes. My fingers are starting to deform, becoming bent. The doctor suggested it is probably rheumatoid arthritis, since the RA blood factor was more than 100. I have been taking pain-killers since then, when I have pain. My acidity is also becoming worse. I feel that many complaints have attacked me (HG) and I feel weak and powerless against them.

“For the last twenty-six years, I have bleeding hemorrhoids. They were operated on twice but it is still not over. I have been bleeding for the last month now and it is making me weak. The bleeding is going on and on despite the operations. Every time my stools are hard, I have drops of blood. I feel really stressed out. I get frightened to see the blood oozing. My body becomes hot and starts trembling. I become anxious about its recurrence. Will it be cured or not?

“When I think about my complaints, I start to tremble (HG) and I have palpitations. I feel as if my heart is pumping at full speed.”

Observation: she looks as if she is experiencing something. She is breathing deeply.

GM: Be there and describe whatever is happening to you.

P: “My whole body trembles or shakes, even when I sleep. I feel very frightened; I feel a very strange sensation all through my body. It becomes a hopeless condition for me and I feel stressed about the future. What will happen to my body? Will something serious happen to me? I feel as if my blood pumps at full speed, as if my blood pressure rises.” (Pause)

GM: You are describing it very well. Tell me more.

P: “My body trembles and the pressure rises. I feel my disease is not leaving me and I feel very stressed because of that. My blood vessels are throbbing; I feel the pressure rising, and it especially settles over my throat. I become very aggressive then, as if anger has settled there. It is as if everything is choked up and jammed here (HG showing her neck area with both hands). I cannot describe it to you more, I have told you everything. I just know that I pray to God to help me. Many thoughts are crawling in my mind. Suddenly, I am frightened; my body trembles and the pulsations become intense. As if disease is attacking me and I become weak. (Here, she makes the same hand gesture.)

“One more complaint I have is vertigo. It started three years ago when my menopause came on. I used to faint when my cycles started to become irregular. I used to get momentary giddiness in the past as well. The doctor says it must be because of menopause. When I faint, I become unconscious for 5 to 10 minutes. Sometimes, when I sit, I become giddy. I need to stand or sleep first, and then it can settle down. Whenever I sit, after finishing my work, I feel a little giddiness. It started when there were intense quarrels in our house. I feel very tortured by my family members. My husband used to be nice to me but my in-laws are not nice to me. They must have spoiled my husband’s mind.”

Observation: she perceives her family as torturing her, the same way she perceives her chief complaint.

P: “They don’t leave us alone. There used to be many fights amongst us. I was becoming worse by the day. Those times were very gloomy for us. My memory was becoming poor; it felt as if my brain was deteriorating slowly. I was becoming weaker and weaker as the years went on. I felt worse at night and I could not sleep. In the mornings, everything was painful: my nerves, bones, everything was hurting. Small things used to trigger quarrels at our home. Everybody was trying to put me down (HG of putting something down) and suppressing my feelings (HG of putting something down). They were harassing me and I felt powerless against them. I was thinking all the time. They were making plans to make me angry and irritated, but I just bore it, not saying anything and not reacting. Even when I had painful, bleeding piles, they didn’t care. They just hoped that I would die of blood loss and they would be able to put another woman in my place. 

“My life is ruined from bearing these tortures. I feel very sad being with them. I don’t like them at all. My fainting spells are also increasing. Sometimes, I would feel faint after a quarrel and stay in my bed, not reacting to their fights. I’d just remain silent and motionless, pretending I was not awake even though I had regained consciousness. I just listened and waited to regain my strength. Now, I am afraid of fainting whenever I become giddy – I might faint and injure myself. I keep thinking on the one hand of my disease, on the other hand, of the torture from my family members.  

My hemoglobin used to go down to 6 or 7; I was anemic and weak. I tried to stabilize it by taking aloe vera, spinach soup, and other things, as well as many medicines and injections. The bleeding was not stopping and I had my family members bothering me. I lost my hope of recovery from this desperate condition. Sometimes, I think of killing myself by pouring kerosene on myself or drinking DDT. If I will be no more, no poison remains.”

GM: I did not understand. What do you mean “If I will be no more, no poison remains”?

P: “I have been suffering from them for twenty-six years, now no more. After just three months of marriage, the whole story started. The years passed and I just stay silent and not reacting, only bearing the tortures. My physical sufferings have come from them. How dare they? They have suffocated me and I feel like I am in jail. (HG and long pause with deep sighing expressions)

GM: I understood your situation. Now, just describe your experience of being tortured, suffocated and jailed… What do you experience in your mind and body?

P: “I can’t bear this anymore. They are doing this to me intentionally. Now, my threshold has been crossed. I do not care for anything. I can’t be without revenge. It is like tit for tat. I had to fight back but I could not. I feel powerless and constricted there. I feel like torturing them, harassing them. My eyes become bloodshot, as if they are sparkling. I am showing them that if you cross my boundaries, you will suffer.”

Observation: here, I was clear about her perception of the situation, her emotional story, so I wanted to know her deepest experience.

GM: Good. Just describe that experience more. Please be with that experience.

P: (Pause) “My blood pounds hot, my heart palpitates, and my eyes become bloodshot. It is as if someone is constricting my throat. (HG) Someone is strangling me and not letting me breathe… Someone is catching me, grabbing me (HG.) Something is very tight here, tight and stiff. As if everything is accumulated there. I feel powerful, and my anger is at its peak.”  (Pause…)

GM: You are describing wonderfully. Kindly be there and say whatever comes to you.

P: “My whole body becomes heavy. My throat region becomes painful and swollen.

My whole strength, power, everything comes up here. (HG: showing throat region)

As if my energy to fight rises… My anger is at its peak and I feel much more powerful. My throat becomes more sensitive.” (Pause…)

GM: Just close your eyes… and experience.

P: “There is something powerful lying in my throat region. It encircles my neck so tightly, round and round (HG: showing something encircling her neck). It is coiled… like it’s curled up around my neck. It is a brownish black coil, round and round and round (HG: around the neck). My throat chokes up completely… Everything is accumulated here… I may die of choking. Everything needs to come out… I feel like biting them… killing them.”

GM: Tell me about your dreams.

P: “I have very frightful dreams most nights, so I am afraid of going to sleep. The next morning I don’t feel refreshed.”

GM: What are they?

P: “I recurrently dream of someone behind me… A big crane and a tortoise are chasing me… running behind me. Sometimes, I am pursued by a ghost trying to harass me and kill me. Once, I saw many cranes chasing me – I had some of their eggs. They tried to catch me with their beaks, grab me and throw me in the sea. I woke up just in time.”

Observation: here, the same themes of being tortured and harassed come up.

Menstrual history

The patient has been menopaused for three years.

GM: How were your cycles in the past?

P: “The blood was dark red, pouring like water. It would last for 5-6 days and come every 25 days. My menopause started at 38, with irregular bleeding and hot flushes. I am still having hot flushes, and painful fingers.”

Physical characteristics

Food: appetite decreased

Thirst: drinks 2-3 liters of water per day

Desires: spicy food but it causes heartburn and aggravation of bleeding hemorrhoids; heartburn in the morning or when eating less

Aversions: nothing specific

Season: I cannot bear summer. I like winter but my joint suffers in the cold season; hot patient

Perspiration : absent 

Sleep: I often have disturbed sleep, especially after quarrels. These days, I hardly sleep at all.

Understanding the case

In this case, the themes of “me versus you”, “victim and aggressor conspiracies” suggest the animal kingdom. There are issues of torture, harassment, suspicion and revenge, as well as a sensation of constriction, suffocation and strangulation, which confirms the snake pattern. Her loquacity and tendency to jump from subject to subject is also clearly marked.

Characteristics of Viperadae family

Hemotoxicity, pattern of a buildup of anger until it peaks, sitting and waiting, then attacking without warning.

Characteristics of Crotalinae subfamily

When the snake is repeatedly provoked and angered, it might not only ‘load up’ but will actually strike.

Anxiety after fright

Anxiety as if pursued

Anxiety with sleeplessness

Anemia, from hemorrhage

Confirmations for Crotalus horridus

Right side is more affected than left

Hemorrhagic diathesis

Confirmatory rubrics for Crotalus horridus

Min: Delusion, people behind him, someone

Loquacity

Mind: Aversion, family members of

Mind: Unconsciousness, vertigo during

Rectum: hemorrhage from anus

Vertigo: menopause during

Prescription: Crotalus horridus 1M dissolved in water, taken five days in a row

Summary of follow ups

After fifteen days, the bleeding from her hemorrhoids stopped completely and the pain and stiffness in her joints was reduced. Giddiness was also improved.  

After three months, all her complaints were much improved. She had no more bleeding and no giddiness. Her finger joints did not continue to become deformed, and the intensity of the pain and swelling also reduced. She could take hold of things without letting them fall. She stopped taking painkillers. Her sensation of constriction was also reduced. She also improved emotionally and started to settle things with her family members; she was able to control her anger.

After six months of treatment, her all complaints had improved by more than 60%. She had no more swelling, pain or stiffness in her joints. The swelling of the hemorrhoids was also reduced.  Giddiness, exhaustion and acidity were completely improved. Her hemoglobin also started increasing, up to 11gm%, which had never been reached. Emotionally, she was becoming more aware of her state.

Her rheumatoid arthritis factor was 6.45 IU/Ml (1.00 to 20.00) after fifteen months of treatment. She was very happy in all aspects.

Conclusion

This case taught me the wonderful lesson of sitting passively, yet being alert, waiting until  the patient’s different expressions join into a beautiful picture which matches the remedy picture from every angle.

Photo:
Crotalus horridus atricaudatus; Dawson; CC BY-SA 2.5