Keywords: Individualising, Psoric, Anxiety
Case of generalized pruritus
On 10th September 2012 a 23 year old unmarried boy who works on the ship, presented with itching in different places with biting sensation > cold applications, < contact with hot water. Itching in the transverse arch of the right sole, itching in centre of chest with redness on right side
There are complaints of catching cold easily specially in rainy season when he gets wet. Develops nasal voice, itching in throat >warm things, Expectoration greenish. There is burning especially in the right eye.
He wanted to become a chef but did not get support from family. He wanted to earn more money because that earns respect of others. Was unhappy and felt he is always unsuccessful. Irritable especially in the morning, when angry he would be violent with his younger sister. Not so attached to his sister rather was indifferent to her affairs. Always worried also about work since he had not received a call from the ship for last 8 months hence was not mixing much with anybody in the society. He had lost his dearest grandmother whom he was very attached to. Dislikes consolation and has fear of being alone. He was sensitive to all impressions. He is very impatient and has a lot of anticipatory anxiety. He would get angry if told lies by girlfriend. Cannot take contradiction and lacked confidence. He has habit of postponing things, for example his marriage. Felt as if he was very sick and that everything is at risk. There is strong fear of death, which stems from having sex with a guest on the ship. Although he had used protection yet he had strong belief that he has AIDS. Even small pimples would frighten him and remind him of HIV infection. At these moments any amount of reassurance was not enough. Even slight diarrhea from dietary cause would raise suspicion of AIDS infection and had secretly done ELISA test at least 5 times. Each time it showed negative.
Tongue white coated lightly, thirst less and desired for cold drinks
Craved for meat and desired wine but it aggravated his acidity. He also desired sour things like pickles +3. Food Agg- Sweets if eats at night gets acidity. A chilly patient, problems in going to sleep.
Since he was fixed with the idea of AIDS which is an incurable disease and cannot be shaken away due to his hypochondriasis (delusion he is sick with incurable disease). Also the itching in different places was biting type of pain, he was clinging to the physician and complaining like a pest, hence I selected Nitric Acid LM 1, 1 single dry dose.
Follow up after 15 days- Itching 20% relieved. Chest itching still persisted so he began applying some cream. Burning and lachrymation from eyes 95% better. Thirst improved. Scalp still itching from dandruff. No biting pain in abdomen. Irritability 50% reduced. Anxiety reduced by 60%. Some salty expectoration took place after and also passed some offensive stools after the medicine. Sleep refreshing.
It was followed up by his chronic remedy being Lycopodium 10 M, 1 single dose after 6 months.
The case depicts the fixed idea that death is near and yet no physician has diagnosed his mysterious illness. Fancies he will die soon. Nitric acid is tormented by his illness, real or perceived. He is convinced that this will surely lead to his death. He is in hopeless despair. Hahnemann mentions in Nitric acid the ‘Anxiety as if he were engaged in a disquieting lawsuit or contest’ causing uneasiness. Offended by other’s actions or words, they seem to “prick” him, just like their splinter like pains. They feel better when travelling.
Case of panic attacks
On 14th April 2020 a 53 year old teacher presented with poking pain in epigastrium, worse at night time, could not eat anything on such occasions. She would suddenly wake up at 3am and not be able to go back to sleep, since about few days. Then she would read and make notes for her son that he may score better which will relieve her from societal pressure. In fact her problems would begin when everybody is fast asleep at home. On waking she would thoughts of the worst kind. Problems started after her niece was hospitalized and being treated for a bad pneumonia. Since Covid 19 pandemic broke out, she was also suspicious of everybody being capable of infecting her and her family. Her mind would devise strategies how to tackle the problem if her children contracted it accidentally. She banned her son from visiting the gym and took all possible precautions. She had dark circles around her eyes and suffered from constipation since last 20 days.
Her biggest worry was what will happen to her close ones. She wishes to do a course in dietetics so that she can choose the right food for her family. By nature she was a very nervous person, irritable when she makes mistakes and when restricted from doing something that she likes. Her biggest fear was of attending funerals. She was having fear of darkness and kept light on the whole night. She desired for hot black tea. She was thermally chilly. She was worried about her son since he had not decided his choice of career. She was a very emotional woman but took decisions after lot of deciphering. She likes to reason out and cannot support the wrong. Her principles were to serve to serve others with love. Even her mother in law who had tortured her was looked after by her till date. On the work front there were no problems but family problems were pulling her down. She fights for herself in the midst of all sad stories. Her father was a very anxious man and her mother is also highly anxious and fearful lady. Her mother had brought her up in fright, now any bad news freaks her into panic attacks at night. Her mouth would feel dry but no thirst, her hands and feet felt cold and also sensation as if blood is not reaching her brain. At that time she would ask her daughter to massage her limbs and had to move about to relieve her mind at night. She also suffered from a mild backache. She invested a lot of time in building and maintaining good relationships. When upset she would not prefer to eat her meals.
I prescribed her Kali carb 10M, 1 single dose because Kali carb has fear of darkness and has the delusion that there is an abyss behind her referring to the chronic anxiety and invisible threat. Kali carb feels her emotions in the epigastrium and is preoccupied with the future. So many happy hours are wasted for kali-carb in hypochondriac anxiety.
Follow up 5th June 2020 She enrolled for a course on diet and nutrition. No acidity and poking in epigastrium. Sleeps perfectly sound and even when wakes up once at night, she can go back to sleep. Now she can only see her goals and became solution minded. Fear element got wiped off. Her son passed his 12th class and decided his career. No medicine required.
Follow up 7th January 2020 She came with chocolates for me because she has passed her exam in nutrition and scored higher than her counter parts that were of science background. She comes from an arts background. She is proud of her achievement and said that nothing can boggle her down. 3 months ago her aunty expired and she could manage without any medicinal help. No medicine given.
In kali-carb anxiety goes into irritability. She has lot of apprehension and anxiety about her disease. Anxious everyday that she might not get well, troubled ideas about the future. So anxiety of kali-carb passes into health mania. In anxiety kali-carb seeks for company because slightest noise or touch frightens her.
Graphites also has anxiety felt in stomach like kali-carb, but it will proceed into nausea and vomiting specially while the patient is narrating his symptoms. Anxiety goes into sadness in graphites. Graphites is physically restless with anxiety which is relieved by taking a walk. Since graphites is a carbon it is relieved in the open air. In graphites you find somatisation, as in the patient will be gesticulating much, perspiration will be there, likes to eat in anxiety state, constipated and bad taste in mouth will be concomitant to the anxiety of graphites.
Natrum mur anxiety comes on periodically may be before menses and it is not constantly anxiety like you find in other drugs. In Natrum-mur you cannot see anxiety on the face and they talk very firmly because they are disheartened and not disappointed. Natrum-mur has a depressed face. The anxiety in Natrum-mur comes in form of losing the whole battle of life. The helplessness which occurs is responsible for wanting to be alone, worse by consolation and worse by contradiction. Therefore the anxiety of Natrum-mur is an acquired anxiety due to the bad experiences where as they are stronger at the intellectual level. Natrum-mur takes long time to develop anxiety.
Silicea anxiety is an inborn anxiety that confuses her and she does mistakes. In Silicea there is anticipatory anxiety about expectations. Silicea thus becomes totally image-bound, most likely in the family which it needs to hold up.
Arsenic anxiety is visible as agony on the face. It may be manifested outwardly in some specific worry, or in a general mental restlessness, anticipation of troubles, or a fussy meticulousness. There is intense concern about health with fear of death. One can sense his overwhelming feeling that his life and safety are at stake, as in his mind, he has done wrong and he has committed a crime against others who will now try to harm him and who are watching him closely. He draws back and doesn’t want to see anyone; this doesn’t mean he remains alone in his house. He feels worse when he is alone. He needs at least one family member around him. Here again hides the fear of death. “There must be someone here when I feel unwell”. When he is sick acutely and has to visit washroom, he leaves the door open because who will help him when he falls. Overwhelmed by fears (especially for cancer) thoughts of death and the incurability of his complaints. Anxious at night in bed, driving him out of bed or tossing about in bed. The anxiety can already start around twilight. Anxiety can be so strong that it leads to anguish with palpitations with feeling of constriction in the chest. Anxiety will be accompanied by bodily exhaustion. Arsenic suffers from internal restlessness, he in fact does not want to move and doesn’t improve through that.
Anxiety takes on diverse forms and expressions. For example, a person can have anxiety about going insane, anxiety others will observe his apprehension, anxiety of suffering misfortune, anxiety about trifles, anxiety with fear of death, anxiety about anticipating an event, anxiety about health. All these symptoms are part of the patient’s elaboration of psoric anxiety. In the psoric person, we always see many anxieties expressed at the same time. He feels his pulse, cheeks, his blood pressure, and wants the doctor to conduct tests. If psora dominates, fear does not attain its full extent but remains as anxiety, which is the forerunner of fear. If the anxieties increase, the person usually starts concentrating on one topic and becomes truly fearful. Fear is sycotic.
Dr Rajiv Rui Viegas Peres MD (Hom)
Asst. Prof. in Dept. of Materia Medica at Shri Kamaxidevi Homoeopathic Medical College, Shiroda, Goa
Awarded Best Teacher Award in 2010-11 by Shri Kamaxidevi Homoeopathic Medical College, Shiroda, Goa
Received Hahnemann Award in 2018 from The Homoeopathic Medical Association of India- Goa Branch.
Having ten years of experience at Shanti Homoeopathic Clinic, Curtorim, Goa