A 27 year old male patient, an IT professional, first came on 9th July 2011 with complaint of migraine for the past fifteen years.
The headache is on one side, and if it lasts for whole day then it shifts to the other side of head. The pain starts from the right side above the eye. He describes the pain as ‘like a needle pricking’, excruciating. The headache is associated with nausea, especially from eating fried and rich food, which give him indigestion and gas. So generally he avoids such foods.
Causative factors are: indigestion; going too long without a meal; and waking up either too early or too late. It comes at any time of day. Sometimes he gets it at around 11:00 AM and it intensifies till 4:00 PM.
In general anything which he does differently or any change in his routine brings on the headache. The chances of getting it Saturday and Sunday are greater, due to him being off his normal schedule. So even on Saturday and Sunday he has to wake up early.
He feels better by taking a shower, massage, jaljira (an Indian beverage which is a kind of spiced lemonade), sleep, and by taking an analgesic. When he has no analgesic with him then he continues his work irrespective of the pain, waiting for it to subside on its own, or taking an analgesic on arriving home in the evening. Most of the time he avoids the things which aggravate the headache.
Here we get a hint of the sycotic miasm, as he accepts the pain and lives with it, and manages the situation by avoiding those things which cause or aggravate the problem.
He says, “I have to be preoccupied in something. If I have some work then okay, I can manage it (the headache), but if I am sitting idle then I keep thinking about it.” (In the rubric, ‘Thinking of complaint agg.’, Allen has given Piper methysticum, and Boger has given Piper nigrum.)
He feels irritated because of the headache. When it is too much then he diverts his mind by such activities as working on the computer, watching TV, listening to music or talking to his friends or parents, and then he feels better.
It is strange to hear that sitting idle aggravates the headache, so that he has to occupy himself in order to divert his mind, and then he feels better. (‘Mind, diversion amel.’, ‘Mind, occupation amel.
He describes his nature as fun loving. He enjoys being with friends, going to parties, reading about sports, watching TV, listening to music and watching movies. He likes activities that are new or different. He does not like to be idle; he always finds some activity in which to engage himself. He said that he is not a big fan of reading and would not go out of his way for it. In his leisure time he most often talks to his parents, watches movies, or goes out to meet friends.
1. Vermeulen, Franz. The Complete Repertory 2012, as published in MacRepertory Pro, v. 184.108.40.206.
In his work, he likes to engage in a challenging or difficult job, rather than doing the same thing over and over again. His main job is developing coding for different software programs, according to the needs of the customer. He says, “When creating a log in menu on screen, some basic coding is already done. I just do little changes here and there as per the requirement of the client, so that it looks different, so that it becomes interesting. Otherwise doing the same thing again and again is boring – there is no joy, no enthusiasm.” When he gets to do something new then he feels joy and enthusiasm; he feels, “Let’s do this!”
Here what stands out is that in his work he prefers doing something different from the routine – he makes little changes here and there so it looks different. Doing the same thing again and again is boring; there is no enthusiasm or fun. If this is his main sensation then it has to be seen in other areas of his life.
When asked about not being a big reading fan, he said that he does not like reading big novels or stories because it is boring. He prefers that the story or novel be made into a movie, and then he will enjoy watching it. He says, “Why take the pain of thinking and visualizing during your fun hours?”
It is very interesting the way he describes reading as boring, and says that he prefers to watch a movie based on the same story, as it is painful to have to think and visualize – a waste of time during your fun hours. This shows his sensitivity to pain and to boredom. The opposite of this is his perception of movies as fun and entertaining.
When asked about his interest in sports, he says that football is his favorite because the mind is not idle while watching or playing it. He says, “I prefer to be a midfield player rather than goal keeper, because being goal keeper you remain idle; you have to wait for the ball to come to you and only then you become active. Being a midfield player, you are constantly active and alert and that is what I enjoy the most.”
He says that when he was around the age of three to four years old his father traveled frequently. He was very impatient for his father’s return. He says, “For a child, father is all about having fun, no tension at all, and when someone is with you for a long time and then he goes away, you feel bored.”
We see that the sensitivity to boredom and to being idle, and the desire for fun and entertainment, are appearing in all areas of his life.
In food and drink he likes spicy food, “with all spices, because it tastes different.” He dislikes raw vegetables. He very much enjoys eating.
The patient’s headache comes when his schedule is altered or he changes his routine, and it is worse when he is idle. For this reason it comes more often on Saturday and Sunday. Normally during the weekend one is free, doing nothing, and then one goes out to have fun, but the patient has to wake up at his usual early time, and when it is time to have fun, the headache comes. So in order to feel better he keeps himself occupied with some activity or other, and with this diversion he feels better.
When we repertorise these characteristics as follows, we get the remedy Piper methysticum.
His main sensitivity is to pain, being idle and boredom, and this is running throughout the case. His reaction is to keep himself occupied, to divert his attention with some enjoyable activity. He seeks fun and entertainment. Likewise in his work, doing the same thing again and again is boring so he likes to keep changing the task, so that it does not look the same or become routine (monotonous). This type of sensitivity and reaction is seen in plant family Piperaceae.
His way of coping with his migraine is to accept it, live with it and manage it, which he does mainly by avoiding all of the things which aggravate his problem. This is the sycotic miasm.
At the cross point of the family Piperaceae and the sycotic miasm the remedy is Piper nigrum,
black pepper. Interestingly, he feels better by drinking jaljira. This Indian beverage “is essentially lemonade and jaljira powder, and is a popular summer drink in India. It is sometimes served as an appetizer, as it is intended to ‘startle’ the taste buds.” And one of the key ingredients is black pepper.
- Boredom; ennui
- Pain and suffering
- Boredom means: monotonous, unexciting, bland, tasteless, insipid, routine, tedious
- Opposite is: amusement, pleasure, entertainment
3. Wikipedia, “Jal-jeera”. <http://en.wikipedia.org/wiki/Jal-jeera>
4. Sankaran, Rajan. Insight Into Plants, vol. III. Homoeopathic Medical Publishers, Mumbai, India, 2007
- Weakness, weariness giving into boredom
- Dullness, sluggishness leading to boredom
- Desire amusement
- Amusement amel.
- Desire change
- Diversion amel.
- Occupation amel.
- Entertainment amel.
- Party, dancing, music, sex amel.
- Desire travel
- Mirth, hilarity, liveliness
- Unaffected by boredom, pain and suffering
Remedy: Piper nigrum 30C, single dose. A second dose was required in September. Then the potency was raised to 200C, of which he received a dose in January, in May and in July of 2012.
Follow-up on 6th October 2012 (fifteen months from start of treatment):
He said that he is feeling much better. His headache is much less frequent and comes with much less intensity. The nauseated feeling has almost gone. Now he can enjoy all sorts of food. He feels happy with these changes. Now he is able to concentrate more on work or whatever he has to do.
With regards to mood and temperament, he feels generally happy. He is maintaining his schedule of waking early on weekends, but if he does wake late then he has no headache. He says, “I am pretty okay and not worried about the headache, and that puts me in a better mood. Overall I am better by 60-70%.”
The technique that led to success in this case was examining each seemingly separate phenomenon to its finest detail, thereby reaching the point where the patient connects the phenomenon to his core experience, which then can be seen as the common thread running throughout the case. For example, when we asked about a rather casual but somewhat odd expression, that he does not enjoy reading, we found the experience of boredom. Then we saw the same experience in his childhood, when as a child he felt bored when his father was not around, because for a child, father is all about fun and entertainment. Ultimately we saw the common experience of boredom versus fun and entertainment appearing in separate time zones and areas of his life. This constant, common experience is termed the “Vital Sensation”.
Then, having established the Vital Sensation in the case, we can see how the symptoms available as rubrics, such as ‘Head pain, diversion amel. ‘Thinking of complaints agg.’, and ‘Change, desire for’, corroborate the remedy indicated by the Sensation. As pointed out by Dr. Rajan Sankaran in his recent book, The Synergy in Homoeopathy, the end result of using system and symptoms together in this way is a very sure prescription.
Dr. Pratik Desai
Senior Resident at The Other Song: International Academy of Advanced Homoeopathy
5. Sankaran, Rajan. The Synergy in Homoeopathy. Homoeopathic Medical Publishers, Mumbai, 2012.