In this I don’t want
you to find questions as it is quite difficult even with all information. For
me it was very difficult case as the patient is very old and very sick.
85 years old lady came to me in very desperate state
suffering from chronic functional dyspepsia. The main problem is that if she
does not eat every one and half hour, she has a terrible pain in stomach. She
has a benign tumor in stomach 24 x 20 mm, but she has had it since 2005 but pains
have started 2 years ago without apparent reason. She suffers from fibrosis and
chronic hepatitis. She is forced to eat very often and as soon as she eats
something, the pain is gone but relief lasts 1,5 hours only and then in account
of pain must eat again. Eating is only think that gives a relieve to pain. She
does not eat because of hunger but because of pain. Pain is felt as a pressure
that is getting worse more directly proportional to duration of fasting. She is
very desperate (3) due to pains and has depression for which uses allopathic
medication. She is very chilly, must sleep on back, otherwise she cannot sleep.
She drinks in sips but not so often, approx once an hour.
She was telling me: I tried all therapies that exist but
nothing had any single effect to any degree to my pains.
She is taking a lot of allopathic drugs and there are no
other symptoms and this case can be considered as one sided, most probably due
to heavy allopathic medication.
After the remedy was given, the interval between pains
prolonged from 1,5 hours to 3-3,5 hours and became less intense and her
psychological condition improved accordingly. There was no aggravation after
the remedy as she is incurable and the effect of remedy was palliative but it
was only think that affect the pains. Unfortunately I have only one follow-up
after 1 month after the remedy.
Summary of this case for students of homeopathy!
 |
| Functional Dyspepsia |
The most important symptom of the case was the pain in
stomach by eating. The effect of this pain on her psychological level was one
of desperation. The very first remedies I thought of was Arsenicum album and
Calcarea, she was so desperate as if she was dying but none of these remedies
have a second keynote that became GUIDING SYMPTOM of the case for me. I knew I
must stick to that symptom and try to understand the mechanism of the problems
she described and soon I realized that the pains coming at the moment the
digestion stops and when the digestion is stimulated by taking food, the pains
goes away. So I realized that she must keep the digestion active by taking food
very often in order to prevent herself from pains. The relevant rubrics
regarding this symptom are:
STOMACH - PAIN - pressing - eating, amel (11 remedies only
in the rubric, Anac is in first degree and only remedy in 2nd degree is Nat-c
that is not possible to confirm in materia medicas concerning this symptom in
detail)
STOMACH - PAIN - empty, when (There are only 2 remedies, one
in first degree (Petr) and one in second (Anac)
I knew that symptom AMEL by eating is most important for
Anacardium and it is its keynote but I did not know at that time about interval
in dyspepsia in Anacardium and that was the point I had to go to Materia
medica. I choose MM Viva from George Vithoulkas and in Anacardium, in chapter
Stomach is written (MM Viva volume 2, page 316): A general AMELIORATION BY
EATING is a strong keynote BUT SYMPTOMS RETURN SOON AFTER EATING. Pressing pain
in the stomach after mental exertion AND ONE OR TWO HOURS AFTER EATING, DURING
THE TIME OF DIGESTION!
That means that my previous understanding was not correct as
the digestion process does not start immediately after eating bur after some
time. And that, when digestion starts is causing stomach to suffer from pains.
When the digestion is maximized, the pains are worse and then when she eats
again, she interrupts the process and relieves the pains.
I said to myself: well, it fits perfectly but what about
despair of her health? I was thinking about it and try to imagine to be in such
state when one cannot go even for a walk to 1,5 hours without thinking of pain
is going to be here soon. I considered this symptom for something that having
it for long time most of people will be despair but anyhow was not sure and
tried to find if there is some link to Anacardium. In repertory in rubric MIND
- DESPAIR, recovery, of - the Anac is not listed at all. Then I read Kent,
Clarke, Boericke but nothing was found. Finally I opened Hering guiding
symptoms and find in second degree the following sentence: "ANXIOUSNESS; DESPAIR
OF GETTING WELL." And that was my confirmation I was looking for.
Lessons for us coming from this case:
1) Try to understand the pathology process in the whole
before you search for the remedy.
2) If you find something very strong and peculiar, stick on
it.
3) Always focus on symptoms that create uppermost layer if
you see symptoms of more remedies. don’t mix all together.
4) Always try to find in reliable medica more information,
which is one of the most effective ways of learning remedies in detail.
5) Always be observant, try to imagine how the patient
feels, and try to imagine this feelings. If you will do it in every patient
your real understanding of human mind and remedies will improve significantly
Thank you all of you and hope it was not too easy for you
because for me it was a hard nut to break.
Case by: Dr Petra Zach
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