MINDING THE MIND IN THE CLINIC (Understanding Clinical application of Mind Section of the Repertory)

By Dr Ashok Mohanty 9810026564


A male aged 28years was brought to me straight from the hospital against the advice of the doctors. He was suffering from viral hepatitis, hepatomegaly with ascites and very high grade fever. His liver function test showed:
Serum billirubin – 4.2 mg/dl
SGOT _ 1960 U/L
SGPT _ 2210 U/L
Alk. Phosphate _ 224 U/L

He was in the ICU of the hospital for a week, but there was hardly any improvement neither in the pathological parameter nor in his physical condition. His fever used to be very high and controlled with icing and antipyretic drugs but after few hours it again used to shoot up. He was having severe body pain, violent headache so much so that he used to bang the head on the rails of the bed.

He was so restless because of the extreme suffering that he used to abuse the nurses present in the ICU. Though he was very weak as there was no intake of food since last ten days but he used to throw the hands so as to take out the drip from his hands and few times tried to get up from the bed to go out.

The doctors were trying to ascertain the cause of the fever which can be either hepatic or enteric. This used to annoy the patient and he insisted that he cannot bear the suffering further and compelled his attendants to take discharge against the advice of the doctors. He told them I will die at home than to suffer here.

They brought him to me as they stay close to my clinic.

Pt: I don’t have any energy left in me, not even able to sit down. I get very high fever with severe body pain and headache. That time I want to just lie down and don’t want to talk to any body nor like anybody talking to me.

Dr: Why you came out of the hospital against the advice of the doctor?

Pt: For seven days they were just taking samples and samples and administering different drugs but there was no relief at all. They were not allowing me to lie down peacefully even for a minute. Even at the mid of the night they used to wake me up and take BP and temperature. That was disgusting. I couldn’t tolerate further. It is better to die than to suffer in this way. Please give me some medicine so that I could sleep properly and get some energy to do my normal activities.

After this much talking he was so much exhausted that he was just lying on the couch without any movement.

If we analyze the statement what he said in the clinic and the situation in which he came out of the hospital then it will be easy to find right remedy for him.

The first requirement of the patient was energy that he lost in the past seven days during the sickness.

When the patient tells us in the clinic that he is short of something, or he is unable to perform or he has become weak because of the prolonged sickness it can be taken as “DELUSIONS - poor, he is” from the Mind section of the repertory.

During the problem he wanted to lie down with out talking to anybody and wants no body should talk to him. This can be taken as ”QUIET; wants to be” and “DISTURBED, averse to being”.

Then his ultimate need was getting proper rest as he couldn’t get in the hospital for the last seven days. This can be taken as ”REST - desire for”.

If we repertorize all these four rubrics, we get Nux Vomica as the remedy. A dose in 30 potency settled the case in 24 hours. His fever came down to 101 and he got very good sleep in the night and started taking fluids orally.

After few days the liver function test showed marked improvement.

Serum Billirubin _ 1.1 mg/dl
SGOT _ 26 U/L
SGPT _ 39 U/L
Alk Phosphate _ 112 U/L

If we analyse the condition in which the patient insisted to get discharge instead of his serious condition and against the advice of the doctors that state can be taken as “Defiant” in the mind section of the repertory. This means the person will openly and boldly resist the authority, defy the authority.

Let us try to understand few important points of Nux Vomica in the perspective of this case which will help us to understand this type of patient in the clinic.
Most of the Nux vomica patient’s come to us when there is very less energy left in them during sickness.(Delusion Poor he is).
Before that they would have taken utmost care and precaution to come out of the situation themselves (carefulness and cautious) as they are very positive and optimistic about the situation and they have lot of zeal to face any condition (ardent).

After continuous effort for which they have lot of patience (perseverance) when they became very tired to pursue further in their activity to recovery then they visit the doctor to get a break without which their energy level will further go down (rest desire for).

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