A 29 year old patient first consulted us on 30th June 2012, with complaint of cough coming every year between July and November.
The cough is dry, spasmodic and severe. During the coughing he feels pressure in the head and abdomen, feels pain in his ribs, and sweats on his palms and soles. It generally increases after midnight, especially from about 2:30 to 3:00 AM. Regarding the pressure in his head, he said he feels that the nerves in the temporal region get stretched. Each forceful cough makes him feel as if his breath is blocked near the heart, and he feels as if he has to take a sip of water to relieve it.
He also perspires on palms and soles when looking down from heights.
He has some black moles on his face which are slowly increasing in number.
At The Other Song Clinic, the patients are asked to fill out a case record form before they come in for the first consultation. Interestingly, we found that in his case record form, the section on dreams was the most prominently filled out. In the interview, the case did not seem to move ahead further along the lines of the chief complaint, so I then asked about his dreams.
He said that once he was in Bangalore, staying in a bungalow with two of his friends. While they were napping in the afternoon he dreamt of a dead body on a stretcher. The same night he dreamt that he was sleeping next to a window and someone was pulling his hair. When asked to describe the dream further, he said that he was lying on his back near a window, and he felt someone pulling at his hair. He was terrified and began shouting, and then he heard the sound of a lizard. He was shrieking in his sleep and was awakened by his friend. He said that he felt that he was being pulled away in the dream and he was very afraid. He was sweating, while experiencing an overwhelming fear that someone was pulling him away and would do something to him. In the dream he was shrieking, ‘Leave me!’ and crying out for someone to help him. He felt that he needed to find a way to release himself from this suffering as soon as possible. When asked about the word ‘released’, he says, “It is like completing a task as soon as possible, so that there is no tension later.”
He describes another dream, in which he is standing in a church with a friend, and wherever he looks there are dead bodies. He sees there is even a dead body lying between him and his friend. The priest at the church asks them, “Who is with this dead body?” He asks them to take it away with them. His friend then has to leave to go to work, so the patient asks the priest to send someone to help him to carry the coffin. Someone comes to help him, they are carrying the coffin, and on their way the helper slows down. Then the patient sees that the grass surrounding them is full of coffins, which turn shiny, and suddenly from those coffins terrifying faces rise up in front of him, and he starts shouting and running in fear.
When asked about this experience, he says it was like a shock, something sudden, and he was very frightened. His heart rate increased and he felt as if he was suddenly being attacked, “as if something comes on you suddenly.” He was frightened that something would happen to him, that he would be injured.
He goes on to describe yet another dream: he was going to his aunt’s place late at night, when there was no one else on the road. A stranger stopped and warned him against going ahead as the road was bad, but he tried to gather courage and go ahead, as it was urgent that he reach his aunt’s place. In the midst of his journey a dog suddenly ran towards him and bit his hand. He started fighting off the dog and then some more dogs attacked him. He was terrified and woke up shouting for help. In that situation he was extremely frightened and felt defenceless, as if he could do nothing to survive. He said the worst part of the dream was when all the dogs were attacking him from different sides, one biting his hand, some biting his legs and some biting him from behind. He said it was an experience of intense pain and suffering.
He said that at times he also dreams of snakes. In those dreams he is walking and a snake crosses his path.
In another dream, he had gone with his family to a beach and they all drowned, and he was then all alone. He said that in the dream he was watching himself standing on the rocks, and watching them all drown. This was a very sad and frightening dream for him. He said that the experience is of a big, sudden danger. Then he feels very sad and alone, and hollow within, as he has no support. He feels there is no one with him now to give him moral support or encouragement. It happened suddenly, and the experience within him is feeling shocked and benumbed.
As his dreams all reflect frightening incidents, I asked him to tell about his fears. He says that he had great fear of darkness during childhood, especially when he was alone. He used to feel someone was around, as if that person would suddenly appear in front of him and something would happen to him. Even now when he has to walk alone in a dark street at night, he always feels that someone is behind, following him. The feeling is that he will be attacked from behind, that the person will catch him and strangle him. In this situation he experiences intense fear, his heartbeat races, his lower limbs tremble, and he starts to perspire.
His sleep is often disturbed by frightful dreams. He wants covering when he sleeps, and he has trouble tolerating cold weather. Normally he does not perspire much except during physical exertion or when he is frightened.
The clear entry point in the case was the dreams, as could already be seen from the case record form. The case record form often gives us a good overview of the case, even before the patient enters the consulting room. It gives us a fair idea of the patient’s basic concerns, and of where we will find the hot spots in the case. These hot spots, when skillfully explored, can lead us into the patient’s areas of highest sensitivity. And often it is on the full understanding of these most sensitive points that we base our choice of remedy.
When I began by asking about the chief complaint the case did not open up, but when we then explored his dreams it was like hitting a gold mine. Not one but multiple dreams were narrated, one after another, all of which were frightening. The dreams gave us some direct rubrics, but also led us into the patient’s core experience. One of the most remarkable things about homoeopathy is that if you probe deeper into each phenomenon, you come ultimately to a core experience, and when multiple areas are explored in this way, you find one common theme, one experience running through all areas.
For this patient, everything came to the common experience of a sudden fright, a sudden shock which comes when least expected, and leaves him benumbed. The experience in his body is sudden terror, with increased heart rate, sweating, and trembling in his lower limbs. This experience is common to all his dreams, be they of dead bodies, of frightening faces, of someone pulling him away, of snakes, of his family drowning or of dogs attacking. And we found that this core experience is not seen only in his dreams but also in his childhood, in which he had fear of darkness, and in his fear of being alone in the dark, where he feels the presence of someone behind him who might suddenly attack and strangle him.
His active reaction to this experience is shouting loudly, shrieking for help and running away. He gives us precisely the Sensation of the plant family, Solanaceae. The Solanaceae Sensation can be summed up as: violence, sudden, splitting, bursting, spasmodic, apoplexy, violent terror, pursued, life or death, killed, snakes, pulsating, constricting, choking. The active reaction of this family is: senses acute, hurried, shrieking, startling in sleep, spasm, escape, panic, rage, fight or flight reactions, striking.
1. Sankaran, Rajan. Sankaran’s Schema. Mumbai, India: Homoeopathic Medical Publishers, 2006.
The miasm of this case is acute; the patient’s experience is of something sudden, to which he has to react as a ‘do or die’ situation; he has to escape, to get out of it immediately, and he feels shocked, terrified and benumbed. The remedy coming up highest in the graph is Stramonium, one of the acute miasm remedies in Solanaceae. Here I become all the surer of the remedy, as the system and the symptoms were coming to exactly the same point.
From Phatak’s Materia Medica:
Thorn-apple or Datura expends its force of action on the BRAIN, producing marked and persistent disorder of the mental faculty; hallucinations; fixed notions, terrifying delirium etc. Therefore it is a remedy of TERRORS; but it does not in its ordinary effect cause actual pain.
Trembling of limbs. Ill effects of shock, fright;
Awakes terrified, knows no one, screams with fright, clings to those near him (child). DREAD OF DARKNESS,
Fearful hallucinations which terrify the patient, sees ghosts, vividly brilliant or hideous phantoms, animals; jumping sideways out of ground or running to him. Wildly excited; as in night terrors.
Desires company; shy, hides himself or tries to escape.
Remedy given: Stramonium 1M, 1 dose
Follow up, 5th January 2013 (after six months)
The patient reports that his cough is gone. His sleep is very good, rarely disturbed, and he now feels refreshed after sleep. He says, “Now I don’t get any dreams in my sleep. Earlier I used to see frightful faces in my dreams, or my family drowning, or that I was being pulled away. I do not get any of these now.”
He says that he feels he is better by 90%. He has even noticed an improvement in his memory function. He says, “I feel very energetic these days. Now I am very happy, not afraid like earlier.”
This is a case which demonstrates the meeting of the system and symptoms, the remedy being the point at the confluence of both. It also vividly shows what happens when you enter into the points of greatest sensitivity – of maximum energy – in the case. When you focus on those points, going deeper into them with the patient, each will give you an understanding at several levels of experience. Thus you see that the patient is afraid (emotion level) when he sees a ghost (delusion/dream level) and experiences a sudden shock (sensation level), with palpitations and perspiration, and he shouts for help. In this way you see each level effortlessly flowing to the next, giving you an entire phenomenon, helping you to understand the patient and his complaint. The secret lies in tapping those spots which you know are the most characteristic for the case and exploring them to the deepest level, till they all lead to a similar pattern and a common understanding. This understanding then has to mesh with the rubrics yielded by each carefully explored symptom. The symptoms and the system supplement each other to give a fuller understanding of the patient. A case understood from all angles not only gives you a clear understanding of the patient’s medicine, but gives you a greater confidence that the medicine is bound to work.
2. Phatak, S. R. Materia medica of Homoeopathic Medicines. As published in ReferenceWorks Pro 126.96.36.199.
Shekhar Algundgi, MD Hom
Consultant, The Other Song: International Academy of Advanced Homoeopathy
with Dr. Pratik Desai & Dr. Sneha Thakkar, Senior Residents