Taking the case under supervision
Gordana Jujić and Joy Lucas as supervisor
Prolonged cough, bronchitic – Gordana Jujić
Male, age 21
History of respiratory problems, since he was 2 months old; asthmatic attacks several times a year, in November always.
Last constitutional Rx was Clem 30C, given on October 5th, split dose and October 12th, 1 dose (repetition was a mistake and caused agg of depressive mood). Acute episode was in early November, influenza. Since then, cough lasts, not all the time but persists.
Current symptoms of cough, in last 7-15 days:
- Cough is predominantly dry; by night completely dry – irritated, due to flowing of mucus from sinuses through throat and larynx.
He explains: I feel how it leaks like a stream and every time when I swallow, it is hard, as something fatty. Mucus causes tickling and it provokes cough. Usually, cough begins between 1 and 2 a.m. but last night it was better, I slept and don’t remember the cough until 5 at the morning. I think it was because I moved the pillow and slept on the side (was not matter right or left, because he changed) and I think that my head was at a lower level than my body. At 5 cough woke me. Sometimes I am trying to prevent cough and when I manage for a while, it does not begin. How he prevents? I resist cough, inspire deeply or drink a sip of water. When the cough begins at night and wakes me, it makes me angry. I am angry! Why and how? Generally angry. It reminds on my anger in childhood, when I wanted to kill someone, throw and break things.
- Cough during the day: it is loose, sometimes I cough up. Mucus is pretty hard, in pieces, brownish-yellowish. Expectoration is easy but often it provokes me to vomit (without nausea).
- Never thirsty; urination several times daily; stool always watery, several times daily; in the last few days unusually formed; hunger lately diminished; since he took Clem he became sensitive to cold and perspiration which was profuse now is absent; sleeps bad, lately because of cough; never cries, he wants sometimes but cannot; when he is sad, listens music which causes more sadness; often he is sad because his brother gone abroad three years ago, he is missing him very much.
- 5-6 years he has eruptions, big pimples like boils full of pus, deep-seated and painful – occipital part of head, under the hair.
On several occasions, at night, are given Rx that helped, as a rule only for that one night: Sulph, Phos, Nux-v; only Puls worked two or three nights. Ip was given but without result.
Joy: A chronic case with acute episodes.
Any indication of cause, right at the beginning from when he was a child – I was thinking possibly allergies especially with the digestive issues and skin – any other possible maintaining causes?
How does he present, his manner etc and what does he do with his life – a bit of background will be useful.
It seems the tubercular miasm is awake all around the world right now.
1) He was born ill, because mother picked up some stomach virus just before the labour began. During the labour, which was normal (in medical terms) there was a fracture of the right clavicle. So, he was in pretty serious condition during his first few days. Important for his future conditions is something that was figured out six years later – he was vaccinated with BCG in maternity ward, at the same time whit other babies, but: he was ill. From the beginning he was sickly child: frequent ear infections, asthmatic attacks and generally the baby who suffered very much. Too much antibiotics and corticosteroids in first two and half years.
2) Since early childhood he was very angry child, very contradict and destructive. For such a little boy, he behaved unusually malicious. At the same time, very attached to family members and always wanted protection, in terms that he felt safe only at home and in a company of family. He never was interested for company of peers, he felt insecure and frightened. By appearance he was typically Tuberculinum child: lean, pale, skin almost translucent and bluish. After treatment with Tub this condition turned into opposite, he gained the weight and became chubby. His rage was not violent as before. All of this was between his 6 and 10. At that time also he had some episodes of nightmare attacks, and they were directly connected with his breathing: he fell asleep and if his nose would just a bit stuffy, he jumped out of bed in a delirious state of fear, did not recognize anyone and ran around with a horrified expression on his face, and it was difficult to wake him up. Then Stram was given.
3) Until 2012, when he was 17, asthma attacks occasionally occurred, but in that period of time few doses of Calc-s yearly were enough to maintain him in enough good condition in every sense. At the end of October 2012 he experienced the worst asthma attack which could not be stopped with available homeopathic skills. For the first time he used respiratory inhaler pump.
4) Since 2012 until 2016: he discovered social life, began to hang out; too much alcohol, marijuana, rage in drunkenness, fights, conflicts, episodes of complete absence of memories of events. 2014: ten years older brother gone abroad, he left home to enroll the faculty; there he was depressed, loss of appetite, insomnia, thoughts of suicide... At early 2015 he decided to leave education, returned home and began to work in father’s company. Sulph was given but without significant improvement – at that time the focus was on his respiratory symptoms and addictions. After Syph 30C, 200C and 1M (weekly) condition was much better.
5) Clem 30C was given as I said. There is improvement. Although he has this prolonged cough, his need for inhaler is less than in last several years. Generally, his breathing is much better. He had agg of depression, it lasted 3-4 days, but after that he decided to start psychotherapy, to stop using alcohol and other stimulants.
6) He has a lot of fears, thinks too much about everything, great perfectionist. Walking encyclopedia. Researcher but quiet, for his soul, not to fascinate others. Yet, with that behavior, he is interesting to others and in some way he loves it. He learned to play guitar alone, without teacher and school.
Joy: When there is anger and rage on the one hand and yet a need for protection on the other this hints of the anger arising from a sense of being trapped or persecuted (in his mind, not necessarily for real) so he needs protecting from that – would you say this is possible?
Gordana: Yes. Sometimes he has delusion that someone chases him, especially in the dark; recently he told that one night when cough woke him, he had the same fear "when I was child and had those horrors and I was running away from mom and dad" and at the same time "some feeling of claustrophobia as I will choke". I asked to explain: "It is the feeling as if something or someone is sitting on my stomach; as if I am chasing myself, I persecute myself."
Joy: Now that we have some new information about this person we see the case more clearly.
There is a possibility of vaccine damage by BCG and this could be tricky to cure but we try.
He did well on Tuberculinum and this might be needed again, possibly also Bacillinum could be considered.
I would like the following rubrics be added to the repping, if you agree:
- cough waking night agg
- cough waking after midnight - 2 am (I think the time modalities mentioned are important)
- cough suffocative and cough choking - these trigger his fears
- fear of persecution
- anger violent
- delusion trapped
- delusion deceived
- pressing as of a weight (this is the nearest I can find for his feeling of the weight on his stomach, it is in generalities)
I am hoping this addresses his clear sense of fear coming from a feeling of suffocation, choking, persecution, which are often bound up together – a kind of feeling trapped = always trying to run away and angry that he cannot.
If you can add these I think you will find a remedy coming to the fore which demands a closer look, especially as it is already in the reppertorization.
We shall see.
Gordana: Okay, I see the remedy. In this last episode that remedy was considered every single night but was not given. When he was a boy and had attacks, Dros helped instantly every time.
One interesting thing: several days ago he told "I have a sense that in my stomach I have a carnivorous plant and it devours my inside."
He just answered my question about "deceived" because I was not sure: "I always have a feeling that someone wants to screw me." (Sorry for rudeness, client said so.)
Here is reppertorization and I think it could be useful to make DD.
Joy: More than useful. Although it is tempting to use that nugget of a rubric 'cough dry at night and loose by day' it is better to cover all your options either by careful study of materia medica after the repping or include for the repping, other rubrics that also cover the symptoms and in the case of Drosera you would add 'cough loose' and 'cough dry' and even 'alternating states' – put this lot together (all big symptoms in Drosera) and you have the same as 'cough dry at night and loose by day'.
I take it you will prescribe this or do you want to study other remedies in the repping.
Gordana: Agree. I intentionally kept these symptoms so I would not lose them, because of the differentiation.
Drosera – Caught in a cough
These remedies have appeared in a broader choice:
Kali-c; Lyc; Phos; Lach; Sulph; Calc; Puls; (Caust, Verat, Sil, Sep)
Most of Rx which came to the top prevalently was here because of their cough and cough-related symptoms. In this case analysis it was mitigating that were found and used relatively small rubrics, for cough as well as mind symptoms, which finally led to the choice of the right Rx.
Contains all the important cough symptoms including one of modalities, in very small rubric
Cough; midnight; after; two am.; about; waking from cough:
arist-cl cocc DROS KALI-C kali-n syc-co
On physical level, it covers: asthma, spasmodic breathing, waking from cough and some other symptoms characteristic for this kind of respiratory problems.
According to Sankaran, Kali-c person has vital fear and reactivity. Thus they are very attached to family, what we can see in this client. At the other hand, Kali-c person has aversion, quarrelsomeness and rude behavior to the people on which depends, which are closest. Phatak: Quarrels with one’s bread and butter
According to Morrison, Kali-c is loyal, moral and in that sense socially correct person; rigid. It is noted that the disease does not develop to the level of depression and deeper mental disorders. My conclusion is that Kali-c is so to say superficial in that regard, what is connected with its rigidity, at all levels.
Although pretty low on the list of repertorization, Lyc was taken into consideration because the client by his nature has some significant features of this Rx. Speaking of cough, there is no need to list symptoms – they are obvious and well known. Admittedly, it is not in rubric Cough; night; agg.; waking; him, but we have it in: Sleep; waking; cough, from
Lyc also has fear of persecution (discovered in our last analysis). It has violent anger too.
At the end of 2014 it was given as constitutional Rx when client showed mental and physical picture of Lyc. At that time he was showing condition which included: feeling of less value; egotism; need for self-control; fear of intimacy. There was improvement after Lyc LM/01 and Lyc LM/02, but later as this Rx stopped to work. My conclusion was that Lyc did its job.
- Crossed rubrics: Cough; choking / Cough; suffocative give us 79 remedies of which we can single out along with the aforementioned Lach, Puls, Sulph, Ant-t, Phos, Calc… It would require useful but in this case unnecessary explanations. Verat also was very interesting.
- So we come to Drosera. I will not enumerate the symptoms or repeat what we have already concluded through the analysis. I want to point out something that is of much greater importance than choice of Rx in a particular case.
We started of persistent cough and at the same beginning it was clear that here is a chronic case in one of acute episodes. We had cough symptoms with some modalities. There are hundreds of remedies. I have to say that I even didn’t present the whole case with all its episodes and variations. First repping had nine symptoms and Dros was on fifth place.
By researching symptoms of cough, we came to fears and delusions, but not according to Repertory, but relying on Materia Medica. At one moment, starting of “cough suffocative and cough choking - these trigger his fears”, we get: - fear of persecution; - delusion trapped; - delusion deceived. All of these has only Drosera.
I want to emphasis two things:
1) As Joy said at some moment of analysis, only studying of Materia Medica can lead us to the right remedy.
2) Nature by itself is unmistakable. Every single physical symptom shows essence of being/phenomena/order and disorder. We are dealing with the most powerful medicine – homeopathy is a real natural miracle.