Uranium nitricum: recurrent tonsilitis

I have incorporated Dinesh Chauhan’s method of case witnessing process (a specialised model of case-taking) into my clinical practice for the past couple of years. To me, it looks like a complete method where everything is in a cyclical pattern, where the patient starts a case and ends with the same thing. Every aspect of the case witnessing technique can be explained scientifically, step by step, and it can be accurately reproduced case after case. 

Here is a case from my clinic done with three steps of the case witnessing process (Passive, Active and Active-Active.)

D=doctor, P=patient, HG= hand gesture

A seven year old male child consulted me in February 2009 for recurrent tonsillitis.

PASSIVE CASE WITNESSING PROCESS:

D:  What happens to you?
P:  My nose gets blocked; it gets pinched. (HG:  pincing thumb with ring finger and 2nd finger). It gets pressed. My nose gets blocked and something sticks in my nose, it’s a sticky feeling. I feel as if my nose is all stuffed up. When my nose gets blocked, I breathe through my mouth. My mother says not to breath through my mouth otherwise my teeth can come in front.

D:  Your teeth can come in front?
P:  Yes. It looks bad. People will say “Look at his teethhow his teeth….eeeeeee….yaak!” I will have to put strings (braces) on them to make them straight. We have one person in my dad’s office. His teeth are like this. (Patient shows a facial expression.)

D:  So, what happens?
P:  It hurts sometimes. And it looks dirty. It looks bad, like a dust-bin… dirty.
(He describes his problem in a very peculiar way. He says if the cold persists he will not be able to breathe, then his teeth will protrude and it will look bad, like a dust-bin.)

D:  I didn’t understand, tell me more.
P:  Everything dirty is there in the dust-bin. It contains banana peels, broken torches, cameras, and dirty dirty things; food products that we don’t eat are there in the dust-bin. There is a dust-bin in my playground; lots of dirty things are inside it. Bad smells come from that dust-bin.

D:  What else people will say to you? Tell me more…
P:  They will say that my teeth are pushing forward…it is looking bad… my teeth look like zig-zags. I should replace them with artificial teeth, and then people will say, they look good. Then, I will feel good. It won’t feel dirty like a dust-bin. I will feel beautiful. Nice things are called beautiful. Good and nice!

D:  What do you mean?
P:  I and the entire universe are good. We live on the earth that is in the sky. The earth and I are both are good and nice. Earth is very beautiful. Sometimes, other people come from other planets and trouble the earth. They destroy the earth.

D:  Oh really? Tell me about it…
P:  There are bad people who are happy when they trouble the earth and there are good people who do not trouble the earth. If bad people come to the earth then the earth has to fight. Bad people win if the earth does not fight. They destroy the earth.When bad people come to fight we should show them all the power that we have. So, even if they come to fight we will win. We should not lose. If we lose, our country will be gone. People from that other country will throw dirty things on our country. They will make our country like a dust-bin.

D:  I did not undertand. Can you explain this to me?
P: The other country will win and burn our flag. They will make our country like a dust-bin and kill all the people in the country. All the people will die. Our country will be destroyed. It will be like a dust-bin. They will take a sword and kill everyone.

(From the nose, the story goes to “beautiful and good”. Then, he goes on to say: “I and the earth are good. People from other planets come and fight. They will make our country like a dust-bin.”  So, in the course of his description what comes up as a common factor is the image of things being like a dust-bin! This looks like the focus of the case, since it has come up in different areas unrelated to each other, and so I become Active from this focus).

ACTIVE CASE WITNESSING PROCESS:

D:  You are talking about a dust-bin…..can you explain that to me?
P:  Dust-bin means bad. Waste material! Dust-bin means that someone throws banana peels, broken objects on the entire country, and people die from the smell. All the country and the world die.

D: Tell me about ‘dust-bin’.
P:  It destroys everything. The earth will be broken.

D:  The earth will be broken?
P:  Earth and our country will be broken. There will be lava in the country. Everything will burst like a volcano… and everything is destroyed. Broken pieces all over; broken completely. Lots of lava comes and kills everyone. The entire country dies. If a bomb is thrown on the country, it destroys everything and kills all people. Lava comes out because the earth breaks open and burns everything.

D:  What do you mean by "someone throws a bomb and the earth breaks?"
P: The enemy throws a small bomb which explodes and all the pieces go all over the country and the earth breaks due to it.

D:  So what happens due to that?
P:  No one will live. The whole country will break. All the houses and trees will break and there will be nothing left. The bomb will break open the earth and lava will come out. That will burn everything and we will not be able to breathe.

D:  "Cannot breathe" means what?
P:  Because the nose will become like this (HG: shows the same pinching action.) The nose will stick together and I cannot breathe. I will suffocate. The lava is very hot and it turns everything into ashes. All the houses burn, all the trees burn, all the animals die and all the people die. Only America does not die since it throws the bomb.

D:  Tell me about this ‘destroyed’ a little more.
P:  See, I will show you.

ACTIVE-ACTIVE CASE WITNESSING PROCESS:

(Patient now talks while drawing.)

P:  This is the earth and this is India… this is Pakistan… and this is Russia… Now the bomb comes and breaks the earth, and lava comes out and this cheetah starts running but he is also killed, and these houses and trees get destroyed.

(Patient draws two more drawings. His description of the drawing portrays the same themes of destruction caused by a bomb).

D:  So, tell me about this bomb?
P:  Bad people throw this bomb and that creates an earthquake.The bomb is very tiny but when it bursts it destroys everything. The entire country!

(The child was done with what he had to say, so I called his mother. I did not get any significant information from the mother’s history during pregnancy. However, she tells something very peculiar about the patient.)

M: When he was very young he used to play this game - he used to put all his toys in a big bag and tie it up. Then he used to stand on the table and say “this bag is a big bomb” and then he used to drop it on the floor and say “everything is gone, everything is gone”.

Case Understanding:

In the passive phase of case witnessing the patient describes his nose blockage and ends by saying his teeth will look like a dust-bin. Then, he moves to his imagination where there are dirty things being thrown on our country, there is a big destruction and finally, the country looks like a dust-bin. Thing converting into a dust-bin is a very peculiar expression that comes repetitively, in two different areas. Taking ‘dust-bin’ as the focus, I become Active in the case to understand his perception about ‘like a dust-bin’. We realize that from dust-bin, the description moves to destruction, killing, the end of everything, destruction of the earth, attack by an enemy, destruction by a bomb, lava, earthquake, etc. So, from dust-bin, he moves to destruction. Besides that, he connects his chief complaint of inability to breathe with a similar hand gesture of pinching his nose to describe the effect of bomb-destruction and bursts of lava. His experience with inability to breathe (as expressed by his hand gesture) both during his cold episodes as well as during destruction is one and the same. That confirms that I am on the right track, and that understanding about the ‘destruction’ will lead me to the core experience of the patient. So, I become Active-Active at this point. In this last phase of case witnessing, he describes through his drawings how this destruction is caused by a bomb that kills everyone; no one is left alive, and everything is destroyed, including humans, plants, animals and the earth itself. The bomb blasts into pieces and destroys everything. This is the centre of the case. Interestingly, his mother confirms this by describing the game that the child played, where he would emulate throwing a bomb and causing mass destruction through his toys.

In the case, the description of breaking, of total destruction of a structure point towards the Mineral Kingdom.

Row 7th: mass destruction caused by a bomb that destroys the entire country, including human beings, trees, houses, animals.

Prescription: Uranium nitricum 1M (The level of experience of the patient is Delusion.)

 Uranium nitricum proving by Dr. Sujit Chatterjee:

Dreams/delusion of explosions, bursts, war,die, deathDelusion, about to die

Follow up summary:

March 2009:

M:  He is doing fine. He has not had any attack this month and he is sleeping peacefully, not snoring - he used to snore a lot before. The nose seems to be free, not blocked.

Plan: Placebo

May 2009:

P:  I have a minor cold with green discharge, but no fever! I was fine for the past two months. I had a fever once but your medicine (Uranium nitricum) helped me.

M:  He recovered in a day. He did not need anti-inflammatory medicines. Now, he is more energetic and does his homework on time. He swims daily and he is going to participate in a tournament as well.

Plan: Placebo

August 2009 (phone call):

M:  He is doing extremely well. He has not had any attack of tonsillitis for the past six months. This is a remarkable achievement. I haven’t visited the paediatrician in a long time. He has become more attentive. His appetite has improved. He has become more thoughtful in his actions. He does not break his toys any more!

Plan: Placebo

December 2010:

P:  Doctor, I got a dream. I saw a bright light and God in my dream. He said “I have stopped all the people from fighting and making bad things like guns and bombs.” He said there will be no more war.

Interestingly, I found the following rubric from the Uranium nitricum proving by Dr. Chatterjee: Dreams of God, hears voices of God

The child has improved consistently, and now follows up with me only if he has a cold.