Anamnesis: End of May 2000
Patient: Young boy of 27 years.
Disease Diagnosis: Ulcerative Colitis with Avascular Necrosis of head of femur.
“I am taking Ayurvedic treatment from the Bombay Hospital."
C: How did you realize that you have a problem in the hip joint?
"I started having pain in the back in the left side. X-rays were taken and than I started getting pain the right leg. It was diagonal affection- this right shoulder and left hip. I started feeling a difficulty in walking. My mornings are very restricted. I limp." (The reports showed Avascular necrosis of the heads of the femur, but the shoulder joint x-rays were normal.)
C: When this happened?
C: Before this were you perfect?
"Yes, except for the Ulcerative Colitis."
C: The Ulcerative Colitis is fine?
"Yes." (His papers showed that he had received steroids-up to 120 mgm daily for nearly one month and this could have been the reason of the hips getting necrosis, one of the known side effects of steroids-in the susceptible!)
C: What was the first symptom, the back pain?
"No pain in the hip joint, the buttocks, and than the legs. It went down to the ankles, the thighs and the calves. Before it never used to pain simultaneously. Like one leg would pain and than the other. Now both the legs are paining together. But not the same place, it is like the left hip pains and the right calf is paining."
C: What reason?
"May be because of stress."
C: What stress?
"I used to work on the Riggs on the ship. When I had the ulcerative colitis I was in Miami. I was hospitalized. I used to drink."
C: Tell me about your life at that time?
"Twenty days I was in the hospital. No relatives no friends. It was terrible. Maybe I used to think a lot at that time. Before that I had no problem with the job…Maybe because of the stress?"
C: You were all alone?
"Yes I was; except for the nurses. At that time I lost 10-15 kg of weight in 10 days. I had gone down to 48 kg from 58 kg. Nowadays I feel that my eyelids are heavy. I get headache and weird dreams-Lack of sleep and weakness. And neck pain."
C: It was terrible you said, those 20 days?
"Yes after that I cannot walk alone. I had to hold someone. I was like an old man. Now I can move with the Ayurvedic treatment. It is only since today that I started the Yoga. "
C: What exactly happened when you were on the trip?
"I had diarrhea with bleeding and even after taking the medicine I was not recovering. I was in New York at that time and the doctor gave me heavy doses of steroids. For one month I did not respond to any medicine. I used to go to the bathroom 6/7 times a day and than the doctor admitted me to the hospital. I didn’t respond initially but than I responded and later I responded and I was in Myanmar for 3 months. When I came back home it was o-k. Than, I started getting these pains in the hips. I had shooting pains in the legs; I could not sleep in the night. I used to put ice on the place to control pain and feel better."
C: It helped you?
"Yes it helped me. There was too much of pain, it was unbearable. Ice relieved me."
C: And those 20 days in the hospital?
"No one was there except the nurses who came to give me the medicine. I used to feel giddy and eyes rotating and the entire room rotating. The mood was depressed. I was very weak."
C: How did you manage?
"I don’t know how I managed but somehow I went through it. It was really bad. No one would like to go through it. Just imagine going to the toilet 15-16 times a day. The abdominal pain was also unbearable. Even on sneezing I would get pain in the abdomen. Now also if I breathe deeply I get pain in my legs."
C: You were afraid at that time?
"Yes, I was all alone. And I never responded to the treatment. Doctor said that if you don’t respond than we would operate on you. I thought what would happen? Now also I think of it sometimes."
C: You had to leave the job?
"Yes I had to resign, as I could not even stand. I couldn’t move. I think what will happen? "
C: What do you think what will happen?’
"I want to get better. Doctor told me in 5 months you will be better, but now it is 6-1/2 months of treatment. Doctor said he had expected 80% relief but nothing is there."
C: What thoughts?
"What will happen tomorrow? I have to get a job. I have to earn. I have my whole life in front of me. My life is in jeopardy."
C Situation at home?
"When I see it is getting worst..."
C: Who are there?
"Mother, father and a younger sister…my father is retired and is having paralysis."
C: Upsetting you?
"Yes I am also engaged and if things go like this, I don’t know what is going to happen."
C: How has she taken it?
"O.k. Could you help me? "
C: Yes… Tell me about your nature?
"I am a good person. I like to move around. I like sports. Whenever I get time I play football. I go out with friends and play. I think a lot. Maybe I am emotional. If some one says something to me I get hurt. I care about people. I like to help others. I like to do prayers. Basically I am out going person. "
C: You are in the church?
"Yes… I tend to cry a lot. I am cool tempered. But once in a while I can get angry. But since 2 years I get irritated very fast because of the changes in the health. Initially I take time to meet people and make friends, and to converse. Later on as I get used to them I am very free.
In studies I was average. I had no problems in studies or getting a job. Nowadays I think of the future. What is going to happen tomorrow? What if my engagement breaks? What will happen if I don’t get well. I get weird dreams because of lack of sleep."
"Day before I saw that my sister was getting married. I am going to the church in just shorts and a banian (brief)!"
C: Describe this dream?
"I have to go to the church, and since it is my sister’s marriage I must be in a suit. But I am in shorts and a banian. Normally our dress code is a suit."
C: What does it mean to you?
"I don’t know."
*C: Imagine this happens in real life, how will you react?
(In footnote 9 to Ã‚Â§ 16 Hahnemann writes,“Most severe disease may be produced by sufficient disturbance of the vital force through the imagination and also cured by the same means.” This is integrated with Jung’s Technique of Dream Amplification and Active Imagination.)
"Embarrassing! It is like people pointing to you and laughing and all the people looking at you."
*C: Than what will happen?
"Maybe I will come and wear a suit."
*C: But what will happen?
"People will stare and laugh at you. My parents and my sister will feel embarrassed."
*C: Imagine if somebody has come like this, how will you react?
"Maybe I will go to that person and ask him to wear other clothes. If he has none than I will give him mine if I know him. If I don’t know him than I may ignore him."
*C: And you will allow him to wear…?
"Maybe I will not allow him to wear, I will ask him who he is and where he is from. If I know him than I will ask him to leave."
*C: If you don’t know?
"I will ask someone to take care of him."
*C: To take care means?
"To take him out of the scene or something like that. No one expects someone to come like this in shorts. Maybe if he is not invited we can take him out."
C: What other weird dreams?
"I dream that some one is coming after me and I get up from sleep. During sleep also I feel the pain when I move from one side to the other. No good sleep so I wake up."
C: Who is chasing you?
"I don’t know. I am running away somewhere."
C: Any other dream?
"I dream of playing football."
C: You are playing football since how many years?
"Since 4-5 years. But since last year I have not played football since I came from Miami. I am not well. After 4-5 months I played volleyball and I got a lot of pains in the leg. Till today I have not played. Since a year I am not walking straight."
"You mean yoga, I have to do it but it is painful. What do you think is it necrosis? MRI of the spine says that I have Sacralisation of the L5 vertebra. Doctor was suspecting Ankylosing. I don’t have a backache now, but earlier I used to get it when I used to sit for long. Before I could not lift up my leg at all, now I can a little bit, but when I sit and try to get up after Ã‚Â½ hour or 45 minutes it is worst. It will pain for sometime. Initial few steps are very painful. When I lay down on the back it is difficult to lift up my legs. Right leg is better. Earlier when I used to sit in an auto it was difficult to move. I had to take the support of my hand than I could get up. Now it is o.k. But I didn’t get results."
C: You than… get these thoughts?
"Even if I can get better in the sense that I can move and get a job! I will be occupied somewhere. I am sitting at home and doing nothing."
C: How do parents react to this?
"Its fine they support me. I feel helpless I can’t do anything. I can’t lift anything. At this age I should be taking care of them and it is reverse. "
(At this there were tears in his eyes but he hide them and wiped them away)
C: You feel like crying now?
"Yes, I have to control myself. Generally if I am talking to someone I am in tears, I have cried enough. My father has paralysis of the left arm and the left leg. Sister is 24 years old. She is worried but she doesn’t show it."
C: How was your childhood?
"Fine, playing. I had financial problems. I had no problems except that once I was sick when I was 4, I had no problems till my 12th year of studies, and than I was operated for sinus. It was in 1989."
C: You never had stomach problems?
C: Your food habits?
"O.k. breakfast, lunch and dinner. In crew the food is not like ours. I had to do shifts. In fact the first few years I was feeling much better over there. I had allergies of dust but when I was in the Riggs, I didn’t have any problems. Whenever I used to come home I would fall sick; there the climate was good, no pollution."
C: What you like to eat?
"I used to like non-vegetarian food, but I stopped now. Chicken and eggs I like a lot. Cheese I never used to like. I used to like milk but I have Lactose intolerance. "
C: After Colitis?
C: You like sauces?
"Chinese I don’t like, but I like Mayonnaise, it is my favorite."
C: You said you are emotional?
"Maybe, if I like a person and he ignores me… Like a friend, if he says something, say just move out, than I feel hurt. I don’t like anybody getting angry on me. I feel as if I have done something, I feel why he does this to me? When I can do something for him, why can’t he?
My sister got angry on me because she wanted my fiancÃƒÂ© to come home and I was to go out with her. I feel bad at that time I felt there is no reason to get angry on this matter. It was not my fault. She started crying at this."
C: You also cry you said?
"If my parents say something to me than I cry. I never used to watch television and now I have nothing to do but to see it, and the other day my mom said you are only watching the television all the time! Than I feel like crying and I was in tears.
I told her that I have nothing to do so I am watching the television. But she said that I am watching it the whole day."
C: What you feel?
"She should have known my situation. She knows that I have nothing to do. I felt why is she telling me this? She should know what my problem is."
Physical Examination: All movements-flexion, extension, abduction, and adduction at the hip joints were painful and restricted.
Diet and regimen (Ã‚Â§ 261)…
Avoid: Meat, Milk, Fats, Alcohol/Beer, Coffee, Bread, Cold drinks, Ice cream.
Eat plentiful: Fresh vegetables, Fruits, Yoghurt (if he could eat without aggravation)
Water: Boiled water
Exercise: Yoga (under supervision)
Secale has the symptom “Rectum Diarrhea cold drinks after agg ”: so he was asked to avoid all cold drinks.
Secale is worse from Ice cream, Fats, Coffee, Beer, so this must be avoided.
Bread is refined flour that must be avoided in all bowel diseases.
(Food Similia: The Individualized Diet by Dr Chetna N. Shukla , IBPP Publishers Delhi, 2006.)
INDIVIDUALIZATION: The Jung Way …
* Twenty days I was in the hospital. No relatives no friends. No one was there except the nurses who came to give me the medicine.
* I get weird dreams because of lack of sleep. Day before I saw that my sister was getting married and I am going to the church in just shorts and a banian (brief)! I have to go to the church, and since it is my sister’s marriage I must be in a suit. But I am in shorts and a banian. Normally our dress code is a suit.
Using Jung’s Method of Active Imagination (MAI) and Amplification (modified to suit our case taking) with the dream image what happens automatically is that that we are able to make an Internal Consistency at all the levels of derangement of the organism!
At the end of the questioning of the dream (where * in the interview) using his Active Imagination and keeping him held to his dream element we are able to make a connect to his verbal expressions (his story). We are able to make a connection to what he has been implying by saying
• No relatives, no friends. No one was there.
• Like a friend, if he says something, say just move out, than I feel hurt.
He felt repudiated/disowned/deserted in the same way one (he) would if one (he) dresses indecently in a wedding!
And his statement…
”In fact the first few years I was feeling much better over there. I had allergies of dust but when I was in the Riggs. I didn’t have any problems. Whenever I used to come home I used to fall sick.”
Also represents him (his other side) repudiating his family and relatives. All his complaints were better while he was away from home! It was not the no dust, no pollution that was helping him. It was an expression of him cutting himself off from his own family/relatives. It speaks of something deeper-he not wanting to share and be connected to the same air/breath that was shared by his family/ relatives.
The Internal Consistency (IC) established!
So now we can without question use the rubrics…
*Repudiated/deserted by relatives
This combined with the rubrics at the physical level…
*Extremity pains cold applications ameliorated
* Diagonal complaints
With the chief pathological complaint of …
*Extremities, Necrosis (Caries) of the bone
Brings us to Secale-cor.
Plan: Secale- cor 30 one dose and placebo daily for one month.
THE ORGANON in this case…
In this case we must remember and understand what Hahnemann says in his Organon in 74th aphorism…
“Among chronic diseases we must still alas! reckon these so commonly met with, artificially produced in allopathic treatment by the prolonged use of violent heroic medicines in large and increasing doses, by the abuse of steroids,( I add for the present times) whereby the vital energy is sometimes weakened to an unmerciful extent, sometimes, if do not succumb, gradually abnormally deranged in such a way that, in order to maintain life against these inimical and destructive attacks, it must produce a revolution in the organism, and either deprive some part of its irritability and sensibility, or exalt these to an excessive degree, cause dilatation or contraction, relaxation or indurations or even total destruction of certain parts* , and develop faulty organic alterations here and there in the interior or the exterior , in order to preserve the organism from complete destruction of life by ever renewed, hostile assaults of such destructive forces.”
(*In his case necrosis-death of the head of his femur)
The necrosis was the result of excessive dose of the Corticosteroids. This aphorism went through my mind many times so when he asked me could I help him, my answer was this…
“ Yes we have something to offer, we can give you a near normal life, but let us take it one day at a time! The medicine I give you will definitely start showing its result in the coming days and we will leave the options open for everything. I cannot tell you the exact time frame but the medicine will work. ”
This reassured the patient and he started the treatment without much doubt.
Follow up One month after the medicine (July 2000):
The dose saw him in good state of physical health; the pains at the hip joints were greatly better. He could stand up from a chair with better ease. He also started Yoga with a friend of mine and both therapies together saw him in better frame of mind and body. The range of movements at the hip joints was better than before but not painful any more. He slept better without dreams.
Plan: Secale cor 200C one dose and placebo daily dose for one month
Follow up Second month after the treatment (August 2000):
The 200C saw him in better spirits in the mind and body. He smiled often. His weight improved from 46 to 49 kilos. He could eat better, he could move better, and he was very positive that the medicine was working well with him. The orthopedic too opined on the X-rays that there was no further worsening of the X-ray findings at the hip joint.
This day I told him not to take any other medicine and not to worry if he had any stomach symptoms. He nodded a yes and asked with worry, “Are you going to bring back the colitis?“, I said “No“
He also informed me that they were planning his sister’s wedding for November. We laughed when I said, “take care that you don’t go in briefs!“
He did well for another 2 months till October. He could jump and move without any pain and discomfort. But his engagement broke.
Follow up Fifth month after treatment (November 2000 First week):
I received a phone call from him from a PCO of a hospital saying that he had severe diarrhoea with mucus and no blood. He was forced to get admitted, by his family, to a hospital for treatment as his sisters wedding was scheduled soon. Fortunately this time he was not put on steroids-only antibiotics and anti diarrheasl’s.
He was allowed to attend her wedding for a day from the hospital and come back and get admitted again for treatment and in the next follow up after the wedding and the discharge from the hospital he said…
“It was as if the dream that I used to see about my sisters wedding came true!”
“Because of the stomach I could not stitch a new suit for my sisters wedding and I had to wear an old suit that I had. We have a dress code, we have to stitch a new suit but I had to wear the one that I had used before and it did not fit me well as my physique has changed. But the wedding went well”.
C: They didn’t throw you out?
(Laughs) “No, they can’t, they know the situation with me and also my father had a prostate problem and he is recovering. We had to go on with the wedding as scheduled because her husband has to fly back to the gulf for his work contract”.
This event in our patient’s life finds its answer in what Whitmont has to say…
“The apparent differences between inner psychological and “outer” material events seems to be irrelevant, as though non-existing, to our transpersonal awareness. Apparently what cannot reach us or be assimilated psychologically by our ego consciousness may, in order to be realized, manifest in the form of an external event pattern.”
At this point in his life-space continuum I realized that our patient was confronted with his feeling of being repudiated, deserted, forsaken by his dear ones. Through this event his ego consciousness was able to assimilate his inner psychological material!
He had lost weight again, was 45 kilos. The hip joints were free but running was still not possible. He had started some herbal medicines too from a Naturopath that he felt was helping him in his bowels. I did not ask him to stop them and continued from where we had left.
His engagement was called off by his fiancee.
Plan: Secale cor 1000 one dose twice a week for two month (in water) .
There was not much change in his movements. The X-rays also did not show much improvement. His weight gradually increased again to 50.
Plan: Secale cor 10M daily; single dose in water (as deviation); for one month.
After this he could run and he started to jog, play and ride his cycle. He could also play his regular volleyball.
He passed an interview at a Hotel Management College for a lecturers post. The X-rays are still the same. They did not clear. He is happy with the movements at the hip joints and is taking one day at a time. He reached his original weight of 56 kilos. Occasionally he complained of gas after eating meat.
He is still doing well with the hip joints and in life. The X-ray changes with status quo-the changes not worsened, the changes not improved. We take it one day at a time.
He still works in the same college, working and traveling daily by the Mumbai trains. He continues doing Yoga. He has stopped all non-vegetarian food. His colonoscopy is clear. He has not done an X rays since 2004, as he is sure that if there were any problem the body would throw some symptoms. He can move his hips well like any other normal person.
1. Organon of medicine By Samuel Hahnemann 6th Edition Translated By William Boericke, by B. Jain Publishers 1997.
2. Food Similia: The Individualized Diet by Dr Chetna N. Shukla by IBPP Publishers Delhi, 2006.
3. What Jung Really Said by E.A. Bennet with an Introdction by Anthony Storr Schocken Books-New Ourk 1983
4. The Alchemy of Healing: Psyche and Soma, by Edward C. Whitmont, M.D. North Atlantic Books, Berkeley, California.
Dr. Chetna N. Shukla
Add: 1, Thelma Apt, Vakola Market Road, Santacruz east, Mumbai 400 055, India
Mots clés: Secale-cor, repudiated, indecent dressing, JungÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢s active imagination, JungÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢s dream amplification, internal consistency, inner sychological material Assimilation, Outer event pattern, Whitmont