The patient, a 27 year old woman came for a consultation due to digestive problems.
Peter (P): What is your problem?
Mrs K: “Ever since childhood, I have had a distended belly, tummy aches, and constipation, but for the last two years my digestive system is really my weak point. I have stitches in my abdomen and it hurts to have stools; I can feel them sitting there. For the last few years, I have stopped drinking coffee; if I try to drink it I get problems. I like to have wine but I get problems from that, too. It is all worse with stress.
In March 2007, I ended up in the hospital’s emergency department because of terrible intestinal pain. I had eaten lasagne and within five minutes I had emptied my bowels in the toilet. The pain was terrible, especially in my upper belly; it was as if I had lots of little knives underneath my skin, and because of the pain it was difficult to breathe, so I started to hyperventilate. In the days before this episode, I was often having problems after the evening meal; cramps and stitches in my stomach and belly, as well as very watery and rapid stools. On the way to the hospital, the pain in my bowels lessened but the pain in my stomach remained. Blood and urine were both normal. An echography and an endoscopy of the stomach and abdomen were carried out but nothing untoward was found and I was sent home with medication.
Now, I drink 2 litres of fluid per day, I eat as much roughage as possible and I cook with fewer spices. I don’t drink alcohol at all anymore. The cramps in my belly have lessened but my belly still swells up regularly and, despite taking Pantazol, twice daily, I still have lots of burps and eructations from my stomach. My stomach still feels very painful; it is a nagging pain, a bruised feeling. I also have pain in my lower belly when I am passing stools, as though it is drawing a vacuum.
Since 2004, I also have problems with stomach acidity; I have used Ranitidine for a long time. I have a sour burning from my stomach to my throat, and burping.
My energy is all knotted up, it is all wrong; I am really tired. It feels like the cramps and the tiredness keep attacking me.”
P: Can you tell me more about what was happening at the end of March, when you ended up in hospital?
Mrs K: “Standing and sitting were unpleasant, and on the way to the hospital my stomach was bouncing back and forth. I felt every bump in the road as an irritating blow; I could have wept from the pain. I felt trapped by the pain. I had stitches in my whole stomach and belly. I couldn’t breathe deeply anymore, not deeper than my chest. My skin began to tingle all over, my lower arms, my face – it was a hopeless feeling, like a sizzling through my skin. Now I have little knives in my belly, with every movement it is as though there is a knife shoved into my belly.”
P: Can you describe that feeling even more?
Mrs K: “It is as though there are points sticking in and they go deeper when I move. It is a feeling as though you have to move, but you can’t move because of the pain. “
P: (I ask more about the points and the
pain, but there is no more information available).
You say that stress can play a role. Has anything happened at the end of March that could have to do with it?
Mrs K: “No, nothing that I can think of.”
P : (I ask more about the ‘vacuum’ feeling, it feels like a blow). You say that the complaints ‘attack’ you?
Mrs K.: “Yes, it is like during a driving lesson, you think that you have everything under control and then the instructor suddenly slams on the brakes. You think, “what in God’s name is happening!” It comes at times when you completely don’t expect it.”
P: What do you mean by “my energy is all knotted up”?
Mrs K: “My immunity, my basic energy level is not the way it was. I am really tired and I feel broken. I have very little resistance, neither physically nor emotionally. My body just doesn’t work; I have no balance or stability in my body. I can’t rely on myself physically. I have some very turbulent years behind me, ups and downs. A new job – in the previous job, I was burned out. I don’t have any reserves anymore, I have used up more energy than I had. This past year, I got divorced (she has been married, last year she separated from her partner, who is a woman). I met a new girlfriend but I don’t have a new house. I don’t have any solid ground under my feet.”
P: No solid ground under your feet?
Mrs K: “Wobbly, my body feels like it has been felled. I feel powerless.”
P: Can you describe that feeling of being ‘felled’?
Mrs K: ”It is as though you are used to leaning against someone but they are not there and you fall on your face.”
P: Someone who you lean against is not there and you fall on your face. How do you experience that? Can you describe that further?
Mrs K: “There is no filter anymore. I become energetically influenced by everyone and everything from the environment, every stimulus comes in; one nasty remark and “Ouch!” Light is sharper, I have to blink my eyes. It is as though I am not there, as though things go through me. I am more of a ghost than a person. Even one rude comment from someone blasts into me, I can’t push it away.”
P: It blasts into you, you can’t push it away...?
Mrs K: “It literally feels like something is shot into my belly; a blunt object, a thud, a slap in the face. I literally close off, I don’t have any answer. It is just like hopelessly taking the blows. A remark from my girlfriend feels like a razor-sharp knife, ouch!”
P: Describe that feeling even more to me.
Mrs K: “It thuds into me, it becomes encapsulated instead of me being able to do anything with it. A bullet comes in and scar tissue forms around it. It is like the thud of a bullet in the belly, like someone with boxing gloves on, who slams me in the belly! A thump! It feels like I am in a boxing ring receiving blows. I would receive fewer blows if I could avoid them but I don’t see the people from whom I receive the blows. I only know that I could receive blows and I don’t have any answer to them. It is as though people walk through me in the boxing ring. They go right through me and over me, no barriers, they step into my space. A razor-sharp knife is thrust into me and radiates out into my body or warmth flies through it...
For the last year I have been doing my best to connect my body and my mind; before I was completely in my head. I was not concerned with my body and I couldn’t feel it very well. I was good at dissociating; if it was emotionally too difficult, I was ‘gone’. I used to walk for hours in the forest, not knowing where I was. I used to use alcohol as an escape.”
P: Could you tell me more about dissociating?
Mrs K: “In the past people tried to get through to me, but I had a film in front of my eyes. Twice I walked through the woods to the rhythm of the sound of my footsteps. I love the trees and the dark. It is like gliding away, as though there are fewer stimuli coming in, as though the world doesn’t come in anymore. No more light or sound. I don’t hear anything, I don’t feel anything. It rains, and I don’t even notice it.”
P: What is this world that doesn’t come in anymore? Can you describe that?
Mrs K: “When the world comes in, I see everything, I hear everything, I see different colours of green, all the details of life. Sometimes that is beautiful and not negative.”
P: Can you describe how you experience, as precisely as possible, when the world doesn’t come in anymore and there is nothing to hear, nothing to feel? What is you sensation?
Mrs K: “It is safe; nothing negative can come in, no more pain.” (She suddenly displays a lot of energy, hand gestures, her body speaks!)
I was almost divorced. I felt closed in, she was always in my space, she claimed my space. I had to pull myself away. I couldn’t move; “get out of my way!” I feel even smaller, I have no defence, no air, my living space is taken away, and there is no room for me. I am suffocating, constricted, under water, screaming but no one hears me!” (At this moment she gets a pain in her belly).
There is no room, breath can’t get through to my belly, I have no buffer, and it blasts right into my core, OUCH! My buffer is gone, everything comes right into me, they are sitting on my pain, if anyone pushes me I fall. I am wobbly. The customs officers should come in between!”
P: The customs officers should come in between?
Mrs K: “I need a buffer, a protective layer. Then I would be able to fall without breaking anything. I wouldn’t be pushed down in the boxing ring.”
P: Tell me about dreams?
Mrs K: “As a child, I had frequent dreams of fire engulfing me. I ran away but was constantly held back by the fire. The feeling on waking was “being pushed into a corner, no escape, completely alone.” Another dream was of not being able to walk through the water and I was swept away by the stream.”
P: Any fears?
“Crowds of people; like at a pop concert, where everyone pushes against each other. I feel every elbow, the space becomes smaller and smaller, I have the tendency to thrash my way through.
Fear of clowns. I associate these with ‘nasty laughs’, ‘suspicion’, and ‘playing the clown’, that is, trying to display oneself as being better than you are; there must be something behind it, something bad will happen. But clowns are also vulnerable people and they are not really threatening. I used to ‘play the clown’; putting on a facade of invulnerability.”
Mrs K has studied Dutch and business communication. She teaches at a poly-technical school. She has had a turbulent year: a divorce, a new girlfriend, a new job, due to losing her old job. She has gone into local politics. At the moment, she has no house and she is living with her partner. She continued to have the feeling of having no solid ground under her feet, and she spent two weeks at home with high fevers. She was completely in her head.
An important life event for her was the divorce of her parents: she didn’t have any contact with her father for 25 years. The only recognition she could have received would have been from her mother, but she never really got that from her. She is jealous of the bond that her sister and her mother have; she has always felt left out. Due to this lack of recognition she felt she couldn’t be herself. She had to fight to be herself, to be strong enough. She says that she is sensitive and open. She can’t stand it if ‘patterns don’t correspond’, that is, if things don’t go the way she thinks they should.
She has been to a gastro-enterologist several times for her digestive problems and she has had various tests done. She has used laxatives and fibre-rich foods but that has not helped. Irritable bowel syndrome has been considered, as well as Crohn’s disease, since she used to have blood in her stools. She has also tried haptonomy with no success.
Other local complaints:
She has had a sort of abrasion of her face, with wound fluid coming out of it. She regularly has aphthae in her mouth; on inspection she now has aphthae. In the past she has had blood in her stools.
Aversion to cheese (3)
Desires ice cream (3)
Allergy to cow’s milk in the past
High fevers in the past
Morbus Pfeiffer in the past (glandular fever)
Sleepless at full moon
Talks and grinds her teeth in her sleep
Pre-menstrual complaints, especially swelling of the breasts
Almost no libido
To solve this case, I have used Rajan Sankaran’s method, making use of the sensations.
What is the realm?
The problem of the minerals is that they experience their structure as being incomplete, or that they fear to lose their sense of completeness. Something inside oneself (a projection of the inner world onto the outer world) is lost or is incomplete, which does not seem to be the issue here.
With animals we often see different sensations, which have to do with survival and competition, which does not seem to be case either with Mrs K. There is no clear aggressor; she speaks of her girlfriend as someone who is in her space, then she talks about “sensations that thud straight into her core”, something that simply happens to her. In her case, it is about one sensation and its opposite (see the explanation further in the text). She talks about sensitivity and about something that happens to her. Considering these aspects, it is clear to me that she needs a plant remedy.
Which plant family is it?
In the first instance I thought of the Asteraceae family (formerly called the Compositae), because of the blunt objects, the thuds, the bruised feeling, the feeling of receiving blows in a boxing ring, the feeling of having little immunity, and high fevers.
What is her sensation? At a moment that she is not expecting it, when she thinks that she has everything under control, she feels attacked by stimuli from the outside: by a hit, a slap, or a stab. It bangs straight into her, right into her core, razor-sharp, and it radiates throughout her body, it flies through her body. This is the sensation of the Apiaceae family (formerly called the Umbelliferae). Sankaran uses the following words to describe the sensation of this family: “sudden unexpected violence or attack, accidents, blows, riots, stab, wound stabbing pains, lancinating pains, preparing for a blow” (buffer cushion, call the customs officers!) Her response is to dissociate, to glide away, or to shut herself off from the outer world’ stimuli. Sankaran describes the opposite sensation of compensation with the words: paralysis, stupefaction, dullness, sleep, calmness. With the Asteraceae we do not see that sudden, unexpected aspect. The aspect of “suddenly being attacked by an overwhelming stimulus” is typical for the Apiaceae.
The insights of Jan Scholten also support the choice of this family. His description of the situation of the Apiaceae (Plant Seminar 5, May 2003) is applicable in this case. They have a need for control, they are thinkers, and they can shut out the contact with the emotions and the body. They can suppress their sexual energy. Their senses are well developed (our patient sees and hears everything, she sees all sorts of details). They have a need for dark (she can shut herself off while walking in the woods). There is often a distant relationship with the mother, which can be expressed by an aversion to, or an aggravation from, milk.
What is the remedy?
I found the remedy by repertorising the plants only. In my repertory, Conium maculatum scores very high (third place). Conium is a member of the Apiaceae. I will show only the rubrics wherein I found Conium:
Abdomen, pain, stitching, knife, as with a
Abdomen, pain, blow, as of
Stomach, pain, sore, bruised, pit of stomach
Face, eruptions, excoriating
Fever, intense heat
General: food and drinks, milk aggravates
Teeth, grinding during sleep
She describes that her body encapsulates the bullet: induration (hardening) of tissues (glands, tumours, breast cancer) fits the Conium picture.
Prescription: Conium maculatum MK
After 7 weeks:
She is doing well at all levels; she feels stronger. For the first time ever, she has gone to Germany alone on vacation, something that she would never have dared to do before because she was so ‘wobbly’. She ‘just stands’ and experiences herself as being grounded, earthed. The world no longer goes through her, things don’t simply overcome her anymore, and she does not let herself be dragged along by her emotions.
One week after taking Conium, she has had black coffee for the first time in three years and had no problems with it. She no longer needs to watch what she eats; she can eat spicy and fatty food. She can also enjoy wine with no problems; in the past she would have had sour eructation. Her stools are only sporadically painful and irregular; in any case much better than they have been and they no longer have an offensive smell. Belly cramps are gone, as are flatulence and burping. On pressing her belly, she no longer feels as though her bowels are sliding.
Prescription: repeat Conium maculatum MK.
After 12 weeks:
After taking the remedy, she had an initial aggravation; some pain in the bowels and a wobbly feeling. A few days later, she is doing well again, even better than before. She feels very well, light, strong, and stable. If she drinks too much coffee, she has some problems but apart from that she has no problems at all. The aphthae have completely gone. She used to have the sensation of “receiving a blow” every day, now she says that she never has it.
I arrange with her to repeat Conium if she has a relapse, or if she has any other complaints, and to call me if necessary.
After 28 weeks:
I wrote to her GP, and then realised that I had not asked her what she was doing with the medication that had been prescribed (Patnazol, Ranitidine), so I phoned her to find out. She had stopped it all on her own, all that she has needed during this time has been one dose of Conium. It was still going "amazingly well" with her.
What was, in fact, this patient’s problem and what is the essence of “the sensation”?
Because I found the remedy so quickly, following Sankaran’s method, some emotional and situational aspects have not been touched on. One could say that the main problem was, in fact, the sensation, but what is actually “the sensation”, or, better said, what is the essence of “the vital sensation”, as Sankaran calls it? Sankaran describes it as a non-human energy, something that changes the life principle of the organism, and which is experienced as an abnormal sensation (The Sensation in Homeopathy, page 421). Through the interference of this energy with the life principle, all activities and psychological processes take on another quality. It is as though the person is wearing a pair of yellow glasses; everything that he/she sees is then described as yellow (Sensation Refined, page 53). The pattern of the energy corresponds with that of the source (the remedy).
Sankaran states explicitly that the vital sensation is the deepest and most constant experience of the person; the principle that binds body and psyche. I draw from this the conclusion that this principle is of a higher order than body and psyche, which would be logical if the sensation manifests itself at the level of the life principle. The assumption that the vital sensation is the deepest experience is acceptable, given that every entrance in the anamnesis leads to the same point, but does this imply that the vital sensation is, therefore, necessarily a higher instance that the psyche? Although Sankaran approaches the concept of the sensation pragmatically, and does not go further into it, his description makes me think of the sensation as an invasive energy, one that disrupts the system: “A plant or animal lives within” (Sensation Refined, page 53); “illness is a song of something else that plays inside us” (Bert Lefevre, Ingrid van de Vel, Seminar SHO 2006)”. So, does the sensation have to do with an external energy and if so, how does this energy come in? Or, could this sensation come from inside? When we consider mind over matter, we could consider the sensation to be the projection of a mental image or film onto the person’s emotional and physical levels? Could we then consider this mental image to represent the central problem of that person? Could that image follow a pattern that resonates with some other energy in nature, implying, perhaps, that the image of the psyche is of a higher order than the sensation?
If I bring the experience of the sensation of our patient back to the mental level, then I could propose her central mental concept as that which, in this life, overcomes her as a shock, and with that which she cannot deal with, because she is so sensitive and so quickly thrown off balance.
One could also ponder on the relevance of understanding precisely what the essence of the vital sensation is, since Sankaran’s beautiful method is useful and workable without being understood. After all, ultimate reality is not to be understood rationally. Perhaps the vital sensation cannot be understood at all because it is, indeed, a higher principle than our mind cannot grasp.
Keywords: indigestion, sudden blows, buffer, Apiaceae, Sankaran, Scholten, Conium
Remedies: Conium maculatum