Case Examples Flashcards
Stress, anxiety began 18 months ago. I’ve some emotional problems. I got involved in yoga which has helped.
I’ve been overeating for 4-5 months, digestion got worse
Early April got stomach pain, mild, but prevented sleep
4/10 pain severe, went to ER. Pain in a diffuse area left side
4/12 ER again, Lower GI barium enema. Dx IBS
4/16 another bout, 6 hrs. Kept me up all night, doubled over (2).
Then upper GI, they said things looked okay, but quick transit.
Problem is primarily at night
Meds haven’t helped (prevocet and Hyocyamine)
4/19 another bout, pain, spasms intestines, lasted 7 hours. Dx IBS
4/21 This bout lasted 11 hours, destroyed me. Didn’t go to ER that time (financial reasons) I’ve lost 5-10 pounds. Sx occur 2 hours after eating.
I get bloated evenings (3). Eat carefully now.
Daytime okay. Eat rice cereal, veggie soup, cottage cheese, apple sauce.
Pains started with diarrhea, pellets of food and liquid. Now stools are solid. Feel bloated. Burping air (3). Aching pain, dull, diffuse. After 4-5 hours get nauseous, occasionally I’ll vomit. Pain LLQ causes backache on left side. Pain is not sensitive to pressure. No position really helps. Restless with the pain, move a lot (3). I’m bloated, and nauseous. Not thirsty. Hot application doesn’t help. Ice distracts but doesn’t’ really help. Maybe lying. Sat. stared at 4 pm.
Fear with the pain (3), when will it stop?
I’m emotionally sensitive (3). I cry a lot; in meetings get teary-eyed if not appreciated. Cry at movies. Embarrassed to cry. Don’t seek consolation.
Married 12 years, wife’s been sober 7 years, she’s in AA. She’s high strung, active, doesn’t communicate well.
Anxiety began 2/2002, work stress, marital stress, communication problems, we withdraw to our corners. Couldn’t focus, would get headaches, like migraines, with visual sx. Depressed, slept a lot. Headache over eyebrows, tunnel vision (2), blind spots, couldn’t read Headaches are mild, but I could drive my car.
If anxious, hurry (3), must do things quickly (3).
Physical exertion helped a lot (2), swimming. In college I ran, biked. Mom 78, healthy, breast cancer age 75. Dad 75, dominant. Prostate removed (CA) age 72
I have close friends.
In relationships, didn’t communicate well, fear of rejection. I always had anxiety taking tests (3).
Coffee aggravates, oversensitive to caffeine (3). ½ cup decaf and I’m wired. Crave sweets but get really wound up from sweets (3) and so mostly avoid them. Like salt (2)
Fear heights (3)
Fear losing my job and can’t support family (3)
Fear looking stupid in meetings (2) (lack confidence at times)
Fear marriage not working
Anxious public speaking (2)
I love to swim. I had to be at the pool by 6 a.m., got anxious about being on time (3). I hurt my right shoulder, had to stop swimming.
Feet cold. Chilly. Feet sweat, cool and clammy Like sun. Rain okay.
I’m a morning person, wake by 6 a.m. Energy drops 2-3 pm. Always a good appetite. If nervous I’ll eat. Very thirsty since the GI symptoms began. I’d come home from work and eat anything I could find, insatiable appetite. Can eat when I’m full. Tidy.
Argentum Nitricum
I have manic depression, daily highs and lows. I’m separated from my wife, we’re getting a divorce. I was sleeping only one hour a night. I took Prozac, it didn’t agree with me. Was on lithium, had 2 good months, the 2 best months of my life, but then it didn’t work.
I get stuck in depression. I’ve tried meditation, positive mental attitudes, affirmations, etc. I couldn’t get out of the depression. I was better on the lithium but started having problems after that initial 2 month amelioration. They lowered the level, I went into a 2 week depression, It took 2 weeks to get the lithium blood levels back up, then I got too high, couldn’t think, tremors in my hands and legs. So they decreased the lithium, I became depressed again, took Zoloft 10 days, felt terrible.
I’ve had this bipolar disease for 25 year, severe ups and downs. I’d hide it from people. At times I couldn’t get out of bed for days at a time. In the manic phase I could get done in 2 days what most people would do in 2 weeks. But when depressed I can’t e with people, can’t face them. With my wife I was critical and controlling.
I want neatness, order. I want control of things, yet I like adventures and challenges, like bungee jumping, parachuting. I have many talents but don’t develop them. I went to medical school for 2 years but depression finished it. I started again, but the depression again came and I couldn’t go to classes. When manic I can do anything. I’ve started successful businesses. I’d start but not follow through. I’d quit jobs, felt my integrity was nothing then.
Suicidal during the depression cycles. I lack the energy to carry it out, but would fantasize driving my car into a bridge or another car, or jumping from a high place. In order to fall asleep at night I’d have to thing how I’d commit suicide.
I have homicidal visions. I’d have to kill other people, my wife and kids, and then shoot myself. I’d see myself in stadiums with a machine gun, shooting people, gunning them down. N never owned a gun. When my wife found out about the homicidal visions or fantasies, she asked me to move out and she filed for divorce.
During the depression I drink tons of coffee. In the manic phase I live on coffee and alcohol. I’ll drink 6 to 12 beers a day or ½ bottle of gin for awhile. I crave sweets, butter, ice cream. I’d yell at the kids or my wife, but have never been physically violent. I saw another homeopath who have me Aurum. I took it for 2 years, it helped a little. A black cloud would descend on me. I’d try to pretend it wasn’t there, but it would last up to 8 weeks. Then the manic phase would come on. I’d stay up all night for days. This state would last for 7-21 days, till I’d burn myself out. I felt I must make up for what I didn’t get done in the depressed state. Eventually I burned out, no energy. About 25% of the time I’m in a normal state, 50% of the time in the depressed state, and 25% of the time in the manic phase. In the depression I sleep a lot, avoid people. It takes a lot of energy to try to hide the depression so I avoid them. I’d try to put on a happy face and pretend. My wife and kids were the only ones who knew. I felt I wasn’t there. I’d try to be there.
My problems started at age 18, in college. I was very serious in childhood, responsible. I used to babysit my older sisters kids a lot, since I was 9 years old. My brother-in-law died when I was 16, so I was surrogate father to those 4 kids. My parents were stressed, alcoholics, no one talked at the dinner table. As a kid I was really allergic to poison oak, would get crusty orange weeping areas. Once it was in and around my eyes, I couldn’t see, thought I was blind. The kids would make fun of me, tease me. I was hurt, angry, would get in fights on the playground if they teased me.
I was outgoing until I was 8 years old. I thought I was special. Then one summer, at a carnival, there was a comedian. My friend and I were in the crowd talking. The comedian started belittling me, humiliated me, and devastated me. From that point on I would be careful, reserved. Before that I thought I had something special inside.
In high school I was a good athlete, got a scholarship to college. The assistant coach who recruited me was a nice guy, and I ended up renting a room in his house. He was away a lot. He was in his mid-twenties. I was in the house a lot with his wife. She would tell me her problems, and I’d listen and try to console her. I had never had sex in my life, I was 18. One day she hugged me, and we kissed. Next thing I know we had sex. We made love several times over two months. Eventually she felt guilty and told her husband, who was furious. I felt so terrible, humiliated. I had betrayed him, who had got me the scholarship. I lost my scholarship, had to move, I was devastated. I felt so low, he had befriended me, and I cheated him. I feel shame and remorse. We were like brothers, how could I have done this? After this I started using drugs, pot, speed, mushrooms, alcohol. I had lots of suicidal thoughts.
I love sunshine, hot weather. I get rashes around my anus, which itch, and can scratch until it bleeds. I had gonorrhea once in my 20’s.
I’ve had the homicidal visions for years. The first ones I had were that I was killing my parents. I felt I was bad, must hide it. It’s worse nights, when it’s dark. I never get that in the daytime. With the homicidal visions, I’m killing my wife, kids, and authority figures. There’s some anger, and a feeling of “This is sad, but needs to be done.” Then I’d feel peaceful enough to go to sleep. This would happen almost every night.
During the manic phase I felt I had a direct link to God, could do or be anything. I’d think I’d never have another depression. Then with the depression, I’d lie in bed in the fetal position, coves over my head, felt I wasn’t in the world, my spirit wasn’t in my body.
I dream that I’m successful, that I was the person I wanted to be, that I wasn’t ill. I have positive dreams like this during the manic phase. During the depressed cycle I have suicidal and homicidal dreams.
Anacardium
The patient’s daughter relayed the following about her father’s condition:
“He stays in bed most of the time with the covers pulled over his head.
He talks about the past a lot, especially about his ‘estranged’ son whom he feels let him down; he has a lot of sadness about this.
He feels he was betrayed by the company where he had worked for many years.
He feels betrayed by his church.
He has violent dreams that he is being hit in the head with a pipe.
He dresses more warmly than what is needed.
He thinks people are making fun of him.
He often draws up into a defensive childlike posture.
He often thinks that my mother and I have poisoned him.
He has a fear of going outside.
In the past, he was very giving; he did a lot for his relatives.
He used to be a very kind and gentle man. He was quiet and read a lot.
He was extremely religious.
He was in the service during World War I.
He tended to be a loner with a few friends.
He often gets out of bed and counts money.
Desires: Ice cream (3); Coca Cola (3); eggs (2); onions (2)
Rarely thirsty
Bowel movements daily, usually long and thin
PAST MEDICAL HISTORY
One kidney stone
Mumps (as an adult)
Surgeries: Inguinal hernia; cataracts removed (both eyes)
Hyoscyamus
9/1/05 Blood sugar was 136, 99 before breakfast, 113 two hours after breakfast.
I get phases of dizziness, and it feels like I’ll pass out. My eyes roll back (2), I get numb and can’t speak (3). It started at age 14, with an anxiety attack (3). These episodes can last for months, then I’ll not have them for several months. I’m always anxious (3). [ She begins weeping]. I get paranoid sometimes. Walking, I’ll suddenly lose vision (3), see blank, feel I’ll fall over. Then I go to see the doctor, but feel worse when I leave his office.
Fear someone is watching me (3). I’ll hallucinate at times (3), see things, people, or animals. I fear a ghost (3) or being pursued by a spirit. Lying in bed I felt a presence lying on me, and it was so frightening (3). I hear noises in the house (3).
Mother is 57, alcoholic, obese. Father is 60, healthy, a genius.
I’m absent minded (3), off in my own little world. Concentration is hard when I try to study, my attention span is bad (2). I don’t use drugs. I onlyI smoked pot a few times in 9th grade. I was the outcast at school, never felt I fit in. I’m not shy at all. I didn’t like any of my classmates, they were petty. I played tennis, was into swimming. I got pregnant in high school. I was always in trouble, fights. Mom would hit us. In high school I was bi-sexual at age 15. I’m not self-conscious. When I got pregnant Mom wanted me to have an abortion. They sent me to Baptist hell for a few months. (A place for pregnant unwed young women).
I’m honest. I used to sneak and lie. I was outspoken.
I fear open places (3). I always feel a presence or someone is watching me. I feel it’s all a dream (2). [Starts weeping again] My mind’s playing tricks on me. A lot of confusion.
I laugh a lot at inappropriate times. I’ll go into fits of laughter when I can’t stop. I get sudden mood swings, crying, laughing. I feel despair when I see doctors about my condition. If I lose sleep I hallucinate. I dream all night, talk in my sleep (2). I’m always talking to someone in my head. I’ll zone out a lot (3), in another world. Memory is poor. I block things out. I make up things. Not sure if it happened or I dreamt it (3). I get impulses. Age 7 I put my finger into a blender. I get impulses to jump from a high place.
Energy is worse mid-day. I like sun, dislike cold weather. I have cold hands and feet. There’s always some tension and pain in my neck and back. My back pops; it’s happened since middle school. Sometimes I get a twisting pain in my abdomen. At times I get a pain like a bubble in my heart or chest occasionally.
Menarch age 14. Bad cramps with every period.
I get bad headaches, frontal or in back of head, a sharp pain, twisting pain. On the top of my head I get a sensation like something is pushing down. I get tingling, numb sensations over my head, arms, legs, hands, my whole body gets tingly and numb at times (2); it comes and goes.
My thoughts are excessive. My thoughts can be visual, like watching a movie.
I love to dance (2).
I prefer dark rooms. I’m not tidy.
Cannibus Indica
This woman has several diffuse complaints. She complains of chest pains of many years duration. She feels burning in her chest that extends throughout her chest and radiates through her shoulders. She says that the pains are aggravated when she lies down. She also experiences heaviness in her chest that is aggravated on exertion, walking, or ascending steps. With the chest pains she also experiences a funny feeling in her head, a giddiness, a lightness, just on the verge of vertigo. She feels like her head is about to spin around and around. This is also aggravated by walking, exertion and ascending.
Another complaint is constant aching all over her body. The muscles, bones and joints ache deeply, as if she is has the flu. The aching is noticed more when she is cold and on going to bed, when the aching can prevent her falling asleep. The pains remaining all over her body, yet migrate in intensity, from a joint to muscle, area to area. She feels stiff in her whole body and has crepitus in most of her joints, especially her knees. She also has pains between her scapulae which feels as if it is on fire.
She tells me she had rheumatic fever when she was three years old, repeated otitis from three to nine years old and hepatitis when she was nine years old. She also had several kidney infections during that time period.
Her other complaint is the constant tiredness. She feels weak and draggy the whole day through. She has no strength to exercise. She had been weak for the past fifteen years. The weakness is more noticed at eleven in the forenoon, and between two and four in the afternoon. She tells me that it becomes so severe she cannot tell me if it is weakness or depression. She becomes weak and shaky at this time, feeling internal trembling with strong hunger pangs. Her weakness is easily noticed on the face: her lips are pursed downward, the eyes droop heavily, and the appearance is one of extreme sleepiness.
On the review of systems we found many symptoms she did not reveal originally. She has very frequent headaches of several types. One is a sinusitis with frontal pressing pains and a post nasal drip. She has this only if she eats dairy. She also gets temporal and vertex headaches that are aggravated by light and ameliorated by lying down. She also develops an occipital headache accompanied by vertigo, weakness and the droopy eyelids.
She develops recurrent pains and a sense of fullness in her right ear associated with crepitus is the right temporomandibular joint that is aggravated by the wind.
Her tongue is cracked near the tip, takes the imprint of the teeth, and has a white coating in the back. She tells me that her tongue swells easily, becoming much larger at times.
She retains water easily, in her abdomen, ankles, feet, face, and around the eyes. There is more swelling in the morning and when she feels the humidity.
As mentioned earlier she becomes hungry at eleven a.m. and at two p.m. She a slow digestion and stays hungry after she eats. With the hunger nothing appeals to her. She has a craving for sweets, cheese, fruits and cool water and has no strong aversions. She tells me that as a child she had terrible motion sickness. She has a daily sensation that has recurred for many years: she feels anxiety in her chest, especially around her stomach and it will extend up to her throat. With this anxiety she must eat. She has two bowel movements a day. She occasionally experiences sharp stabbing pains that shoot up from her rectum.
She gets recurrent colds that are hard to get rid of. When she gets them she experiences severe aching in her chest. She has also had several bouts of bronchitis that were severe. She believes that two episodes with very high fevers and shortness of breath were pneumonia (they were diagnosed as acute asthma). With the coughs she has stress incontinence and will lose urine.
Her sleep was disturbed in several ways. First she cannot fall asleep if she feels too achy. Sometimes in the evening she would also feel the internal trembling that would prevent her sleep. She cannot lie on her left side at all. If she does, within one minute she begins to feel lightheaded, like she will faint, with palpitations, vertigo, weakness all over, and her chest begins to ache. She also gets palpitations on falling asleep, on waking from sleep, from fright and from sudden noises. She will tend to wake with the palpitations between 2:30 and 4 A.M. She sleeps mainly on her right side and her back. In her sleep she will stick both her feet out from the covers. When she wakes both her arms and hands are asleep, she feels unrefreshed, and she has nausea, very much like the morning sickness she used to have. Very often she will not be able to fall back asleep after she awakens in the middle of the night. As a child she had many night terrors: the only ones she remembers are the dreams of snakes.
Though she is extremely chilly, her feet are warm, as is her right hand. She had become chilly in the past three years, since the last bad bronchitis. Also even though she is chilly she cannot wear turtlenecks. If she does wear them she becomes nauseous and will come to the point of vomiting.
She had a hysterectomy twenty-one years ago due to endometriosis. They left the ovaries intact. Before the operation she had severe dysmenorrhea with vomiting; the pain being alleviated by heat. She has a low sex drive and a dry vagina, though intercourse is not painful.
She has weak lumbars that begin to ache if she stands too long and are too weak to support her sitting up straight. She also has sciatica if she sits too long with numbness on the right side of the thigh. The numbness is also aggravated if she stands too long. She has recurrent kidney pains with aching on both flanks. The pains are accompanied by dark cloudy strong smelling urine.
In general she is aggravated in the morning and in the middle of the night, and is worse on the right side of her body.
She denied many mental symptoms though I asked many times. She can become irritable, especially at work. She may also develop a free floating sadness that is without cause. She cannot pin this down for me. The sadness envelops her and she will want to be alone and will be averse to consolation. With this sadness she wants to be alone and cry but is unable to cry. She has a fear of the dark and of heights. Her memory is weak for names and for tasks that she is about to do.
One observation that I can make on her personality centers on how she answered me. I would ask a question. She would look at me with those pursed lips, those drooping eyes, scan my face, and the feeling I would get is “do I trust him? Should I trust him? How much should I tell him?” After every question would come this struggle in her mind. When I asked her about it she burst out laughing but never wanted to talk about it. It seemed to be beyond her self-awareness.
Kali Carbonicum
36y/o male suffers from recurrent bronchitis. He loves the cold, open air of the mountains. Slender. Somewhat excitable. Grinds hit teeth and allergic to milk. Craves milk, sweets, and ice cream
Tuberculinum
46y/o woman complains of hot flashes. Talkative. Jealous of her husband. Vindictive. Can’t tolerate tight clothing. Gets very angry pre-menstrally.
Lachesis
9y/o girl gets frequent HA. Started after her parents separated last year. Quiet and withdrawn. Used to like the sun, but now it bothers her. Craving for salt and cold drinks. Neat and orderly. Weeps alone, never in front of others. Sympathetic. Fever blisters.
Nat mer
38y/o hx of ovarian cysts, moles, breast lumps, insomnia. Mother and sister both had breast CA. Constipation. Insomnia. Giving person, sensitive to reprimands. Loves nature, sea, thunderstorms, traveling, entertaining. Very tidy. Craves chocolate, spicy things, soup, and fat.
Carcinosin
7y/o boy has eczema. Lips and ears are red. Worse bathing. Bright and curious. Leader among the kids. Collects things, but very messy. Tends toward a loose stool. Wakes at 5am with diarrhea if he had sweets the night before.
Sulphur
14y/o girl has digestive problems esp with rich foods and pork. Mother describes her as sweet, with a strong desire to be liked and pleased. She weeps very easily. Emotions changeable. Weeps during the interview. Warm, likes the windows open year round. Hates to exercise when hot. HA during menses. Mouth is dry, but not thirsty. Sleeps on abdomen with arm over the head.
Pulsatilla
47y/o man complains of foginess, poor concentration and memory. Artistic. Likes to stay up late making art. Vital. Loves adventures. Pushes himself in many ways. Likes spicy food, alcohol, grapefruit, and sweets. Suffers from painful arthritis and swelling in his fingers.
Medorrhinum
12y/o boy suffers from asthma. Intense, somewhat inhibited. Asthma is always worse in the rainy season. Has a lot of sebaceous cysts. Dreams of people that have died. Sweat smells like honey. Dreams of falling. Asthma worse 3am
Thuja
26y/o man has joint pain. Also complains of frequent coughs that leave his chest raw. Better cold water. Gets hoarse a lot. Sxs worse when windy and cold. Better since he’s moved to PDX , esp during the rain. Hx of bells palsy. Sympathetic. Actively involved in organizations to protect the environment.
Causticum
33y/o woman has severe premenstraul sxs. Gets intense HA, irratable and angry, craves alcohol before PMS. Come on when she is asleep. Sleeps into the pain. HA on her L-side. Sxs resolve once the menses begin. Strong sexual drive. Tends to dominate conversations. Warm, tends to get HA in the sun.
Lachesis
44y/o man complains of fatigue and frequent sinusitis. Orderly, timid, reserved, courteous and mild mannered. Frugal. Never liked sports or physical activity. When work piles up he gets stressed. Constipated. Agg by milk. Chilly, but craves cold food. Sweats on hands and feet. Doesn’t like consolation. Sensitive to noise. Feels good if he can be out in the sun and relax.
Silica
33y/o woman complains of crampy abdominal pain and indigestion. Likes fat on meat and red wine. Seems like every year she gets food poisoning. Wretching and straining. Confident, industrious, works quickly and efficiently. Highly motivated to excel. If she loses at tennis, she gets intense abdominal spasms. Very chilly. Loves being in a hot tub or sauna
Nux vom
6y/o boy suffers from recurrent otitis media. Restless, distant, hard to connect with. Worse when he sweats, which happens at night when he gets his infxns. Adverse to sweets. Thirsty for cold drinks. Love bread and butter. Seems a bit suspicious. Strong offensive discharge from the ear. Chronically swollen cervical LN. Strong odor
Mercurius
10y/o boy seems serious and sad. When his parents divorced he got worse. Loves church and feels forsaken. Feels as though this world is too hard.
Aurum
48y/o woman has asthma and peptic ulcers. Sxs worse at night esp around 11am and on. Stomach burns from the ulcer that is better with warm milk. Nervous and restless. When she gets the asthma attacks, she feels as though she is going to die. Very chilly. Likes warmth, but likes the window open. Fears robbers, being alone, CA, suffering. Dreams of robbers. Critical. Sharp and controlling.
Arsenicum
62y/o man suffers from bronchitis, pleurisy, allergies, and arthritis. Face swells around the eyes. Sxs worse at 2-3am. Wakes at that time and can’t go back to bed. Pleurisy causes sharp, stabbing pains. Does not like touch. Fear of ghosts. Works hard and careful to always do a good job.
Kali carb
29y/o woman has digestive problems and has to be very careful about her diet. Worse from eating too much or rich food. Likes cheese, milk, ice cream, butter, and eggs. Warm. Sometimes her feet get hot and she has uncover them in bed. Likes the sun, but doesn’t like to get too hot. Worse when she applies heat. Likes cold things. Irregular menses. Sad and weepy before menses and gets her irrational fear that her husband will leave her. Fears the dark, being alone, men, robbers and insanity. Easy to talk to. People person. Has difficulty making decisions. Irresolution.
Pulsatilla
24y/o woman is quite thin and chilly. Likes skiing a lot in the winter. Wants windows open even in the winter. Night sweats. Wakes in the morning tends to be irritable. Romantic person, but gets bored in relationships. Loves to travel. Recently returned from a trip to Asia. Doesn’t like dogs and cats.
Tuberculinum
