http://hpathy.com/case-quizes/case-quiz-3/
First interview
A boy, 9yrs old, is suffering
from reccurrent pneumonia which occurs every 6 months. He developed his
first episode of pneumonia at 18 months of age. His mother says that he
has very bad physical endurance (3). He the first one tired in a group
of children having some physical activity, and the slightest physical
exertion makes him very weak and tired. He is generally very tired and
needs sleep very often during the day when he comes home from the
school.
Observation: he is overweight, with a very pale face, dark circles around his eyes, dry lips and answers “I dont know” to every question.
His sleep is very restless (physical restlessness during sleep) but he sleeps normally. His mother says he is very obstinate.
1st followup (2 months after the remedy)
After
he took the remedy, his energy and psychological state worsened for
approximately 2 weeks. He was very tired and irritable. After this
period of the initial aggravation his state began to ameliorate. He is
not as pale as he used to be; circles around his eyes diminished and
when he comes home, he does not need to lie down and sleep as before the
remedy. Instead of that he does some activity like reading. Two weeks
after the remedy he developed acute coryza. but it was the firs time in
his life when it did not affect the lungs. After 4 days it disappeared
by itself without any interference or medication. He is much more
communicative, and asked me questions during our last interview. Last
week he developed very slight eczema around his lips. He has never had
any eczema in the past. There is no itching and it is slowly
disappearing by itself.
Prescription: WAIT
2nd followup (4 months after the remedy)
He
is healthy, no acutes at all, energy is even better than in the last
followup. He is still putting on weight although he does not eat much or
engage in sports. He can run a long distance without problems.
Prescription: WAIT
3rd followup (6 months after the remedy)
Since
the short acute he had 2 weeks after the remedy was given, he has not
been sick even one single day for the whole period of time. Has lots of
energy, is and doing sports but now he caught a cold when he swam in a
very cold river (18 degrees of celsius). However his lungs were not
affected.
Prescription: WAIT
Take some time to ponder what remedy you would choose, THEN POST YOUR ANSWER AS A COMMENT. …and then see the answer below…..
[toggle title=”CLICK TO REVEAL THE ANSWER“]Analysis of the case for students of homeopathy
The
first thing I spotted when taking this case was that the child has a
big belly and at the same time is very pale. I could see it very clearly
before he and his mother sat down.
My first impression was: maybe it is a case of Calcarea carbonica because of the big belly hanging down and pale face with dark rings around the eyes as these symptoms are keynotes of Calcarea carbonica.
I did not cling to this idea too much but my first impression and
observation led me to think of this remedy at a first glance. Anyway I
kept my mind open.
The first information that came up as a main
complaint was the fact that this child suffers from repeated pneumonia.
Every time he catches a cold, it goes straight to the lungs and he
develops pneumonia. There was no single episode of any acute having a
different course, so it is obvious that the lungs of this child are in a
very precarious state. The question is why? Most probably it’s due to
the strong hereditary predisposition coming from his ancestors.
I knew that Calcarea carbonica
can also cure pneumonia especially, such affecting the apex of the
right lung but such a strong predisposition is not characteristic of Calcarea carbonica. When we see such a strong predisposition, we have to ask about tuberculosis in the family history. If we confirm Tbc in the family anamnesis, we can identify what we call the tubercular miasm.
Here
it is very important to remind ourselves that we never prescribe on
miasm but on the symptom picture. Prof. Vithoulkas says: “every remedy
can cure any miasm, if the symptoms agree.” Precise knowledge of the
theory of miasms can make us think of other remedies in
cases like this when we suspect the influence of miasm, and if we can
confirm such remedy, it can be given with great success. If we don´t
know this theory and we would not have an idea of remedies other than Calcarea carbonica, then most probably we would give Calcarea carbonica
and learn that its effect is superficial and transient. That is the
situation (described in the old books as “when apparently indicated
remedies fails to act”) that tells us there is a possible miasmatic
layer.
Actually, in such instances the remedy which seems to be indicated is not really indicated.
It only looks like the symptoms agree but in reality they don´t and
therefore the remedy given according to this false picture does not act
as we expected. It is very important to realize that the
uppermost remedy is not always clear enough, as there can be just two or
three strong keynotes of it while the majority of other symptoms point
to an underlying remedy.
This is why the qualitative totality is much more important than quantitative totality of symptoms.
What makes us think about other possibilities than Calcarea carbonica is the understanding of what has to be cured first
in this case. This understanding is much more important than mechanical
work with symptoms and it has to be done before we try to find the
remedy, and this is true for every particular case we encounter.
So,
due to the great weakness of his lungs, I suspected the influence of
the tubercular miasm and asked about the family history of tuberculosis.
His mother said: “I dont know about anybody from my family having tbc.”
What does this information mean for us? On one hand we are not sure
about tbc in the family history but on the other hand we don’t have to
exclude this possibility. The truth is that this does not help us in any
way to confirm our hypothesis for sure.
Although I did not
confirm Tbc in the family history, I was sure about the tubercular
miasm, as the course of inflammations shows clearly that the child´s
lungs are heavily predisposed.
The mother told me: “My son is very
tired, very weak, must sleep often when coming home from school.” When
she said that he is very obstinate, my mind came back to Calcarea carbonica but the strong tendency was something that kept me doubting Calcarea.
Then
I realized that it is only the mother who speaks! The child was sitting
there without movement, just staring around, so I put a few questions
to him. I asked very simple ones like, What do you like to eat, Do you
have any fears etc. But the child just answered “I don´t know” to every
single question. I said to myself: what remedy are you looking for? What
must this remedy have? I tried to make it very easy for myself and keep
my thinking process very simple. I knew I wanted the remedy to have
these symptoms as a keynotes:
Strong tendency to lung diseases and strong weakness
When
I realized what I was looking for, I was able to see the bigger
picture, realizing that this boy does not speak. He suffers from lung
complaints, is very tired and weak and does not speak. Why? Because of
this peculiar kind of weakness which affects the chest, the lungs, not
only locally as a tendency to pneumonia but as a feeling of overall
weakness which is AGGRAVATED BY TALKING. I was not sure about it and had
to exclude the possibility that the boy also could have several other
reasons why he does not speak, for instance timidity or aversion to
people or aversion to answer questions (which is typical for Phosphorus –
another remedy having strong affinity to the lungs). But his mother
said: “He likes people. He is not timid and he is quite loquacious.” But
he was not loquacious at all.
Knowing that Stannum is
one of the most important tubercular remedies having a combination of
respiratory complaints together with strong weakness as a keynote and
when I connected this with my observation of “not speaking behavior” and
knowing that speaking aggravates the Stannum patient, I realized that the uppermost symptoms resemble this remedy the most.
Prof. George vithoulkas beautifully describes the importance of this combination in his book essence of materia medica.
In Hering´s Guiding symptoms we can see in the second degree: “face pale, sickly-looking”
In Radar keynotes we see the first sentence in stannum: weakness and exhaustion. Often related to respiratory system.
So my prescription was Stannum metallicum 200C.
Now we are coming to a brief differential diagnosis with some remedies that are close to this case:
Spongia is the remedy we have to compare as it also has the combination of great weakness together with respiratory complaints. But Spongia
is not aggravated by talking. We often (but not always) can trace an
anxious expression together with this respiratory complaint as this is a
very characteristic feature of this remedy. The facial appearance of
this child is giving us the idea of exhaustion.
Ammonium carbonicum is very similar to another two remedies having some resemblance with this case, namely Calcarea carbonica and Antimonium tartaricum. It also has a lot in common with Carbo vegetabilis.
Calcarea carbonica is most probably the underlying remedy and will be needed later when Stannum finishes its work. Coming back to Ammonium carbonicum, we
have to think of this remedy mostly in cases when the lungs and heart
are affected together, especially in cases of cardiac asthma (and Naja
as well ).
In Ammonium carbonicum we can see a strong aggravation from ascending stairs as well as in Calcarea carbonica and Arsenicum album but this remedy is not as much aggravated by speaking as Stannum.
Ammonium carbonicum
has a very characteristic appearance of the face which resembles
Gushing syndrome which is manifested as the cortisone face. The face of Ammonium carbonicum is also pale but very bloated. The resemblance of this remedy with Tartar emetic and Carbo vegetabilis lies in this: all these remedies have a rattling of mucus in the chest. This is most prominent in Antimonium tartaricum in which it is accompanied by great sleepiness and cyanosis of the lips and face. In carbo vegetabilis it is not so prominent but we can see the desire to be fanned and drops of cold perspiration on the forehead (Veratrum album). The difference between Carbo vegetabilis and Ammonium carbonicum is this: in Carbo vegetabilis we have a strong aggravation of all symptoms by lying down while Ammonium carbonicum wants to lie down, especially on his abdomen. Carbo vegetabilis is cold on the periphery (feet) while Ammonium carbonicum is cold in central parts while the periphery is quite warm.
Hope you enjoyed it 🙂
