6/16/2010

MINDING THE MIND IN THE CLINIC

UNDERSTANDING THE RUBRIC : MOROSE, CHILL DURING

I had a case of a lady, age 40 years, suffering from trigeminal neuralgia.

The pain and numbness used to be very intense, so severe that she almost goes mad during the episodes. I gave her number of medicines with temporary relief. She was continuing treatment for almost a year.

This time again she got severe episode of pain.

She called me and told, “I can’t bear it further. Please do something so that I get at least some relief.1 Again the pain is like the earlier attack. It is the most horrible condition of my life. It is as if living in a state which nobody ever wants to live in.3 you only can take me out of this situation.2 Please come down and see me. I don’t see anything which can give me some relief which I need badly now. Nobody understands me better than you. You have only handled my case since one year. My family members might be feeling that I am acting. It is fruitless to tell them everything in detail. Hence, you are the only person whom I can tell everything.4 I open up in front of you spontaneously without any hesitation. Though I have ample intention to tell all these to my husband and son but they don’t understand me. So, in front of them, I hardly can express my feelings.5 The pain becomes so severe that I don’t see any way out of this situation.6 You are the only one who can take me out of this gloomy condition, I will not leave you till I am cured 7. Please, doctor saab, come and see me.“

Her request was so intense that I went to see her at her place which is quite far off from my clinic twice or thrice in a span of two weeks.

I took the following rubrics and prescribed a dose of Camphor 30 which gave her immediate relief and it continued for long with out any recurrence.

  1. DELIRIUM - crying, with - help, for
  2. SHRIEKING - help; for
  3. DELUSIONS - hell - is in
  4. NAKED, wants to be - bares her breast in puerperal mania
  5. WEEPING - desire to weep - eyes are dry; but
  6. MOROSE - chill, during
  7. CLINGING - grasps at others

The state of Camphor shows its extreme low feeling in the way of experiencing the conditions of hell in present scenario. When a person feels that he is in hell, his reactions to everything changes. The predominant reaction is Morose, chill during because of the gloomy scenario.

Morose is a state of bitter unsociable temper, a gloomy and sullen phase where in the individual behaves in such a manner so that others are forced to take some action.

Before explaining you about the state, let me tell you how I earlier used to take this state. I used to combine sadness, irritability and repulsiveness to understand this state.

The information of this patient suddenly made me to realize that it is beyond the combination of these three rubrics.

The patient expresses his feelings in a bitter way, “Tell me frankly whether it can be cured or not by you. (crkbZ, vki ls Bhd gks ldrk gS ;k ughaA)

The tone and manner here is very important in these expressions. “What to tell? (D;k crkmaA) Always I tell you that I am not well, but still you never understand.” (gj ckj eSa vkidks crkrk gwa dh eSa Bhd ugha gwaA fQj fHk vki ogh pht nksgjkrs gksA”)

From the inside, he is very sad and feels the future is dark and depressing and hardly there is any way out. He is in a condition wherein he feels extreme helplessness to continue further with the disease. This brings on a state of extreme irritability and fretful attitude in him which also shows his impatience. Even a single word can show his morose feeling.

Chill is unpleasant coldness of air, lacking warmth, to dispirit, and depressing influence.

When the condition of the patient becomes extremely down where he feels that it is hardly revivable then it is chilly state.

Morose chill during is a state where patient becomes gloomy and feels there is hardly any way out and thereby expresses his despondency with severe irritability and sadness.

Let me explain you another case of a small boy which will further consolidate your understanding of this rubric.

A small boy, aged 4 years, was brought to me for treatment of loss of appetite and ADHD (attention deficit hyperactivity disorder).

The boy was hyperactive, moving around the clinic with speed, not sitting at a place for more than few seconds, continuously telling his mother to take him out and play with him. He pulled the purse of his father from his pocket and then threw all the paper on the floor when his father told him to sit down quietly. He became very angry when his mother admonished him in a strong tone, and threw all her articles inside the vanity bag. When she caught hold of her bag he shouted in a high pitch.

Mother: “He is like this, troubling us throughout; never allow us to take some rest. Because of him I always remain sick; my back pain always remains in worst condition. He will only do the thing which he likes and if we tell him that it is not right he will become very angry and throw everything, even household items from the balcony. Even if we beat him, he will not accept what we say. Though he weeps while we beat him but he will continue doing the same things which irritate us. We are really fed up. If he is not cured then we all will become sick.”

Dr.: “When he becomes angry and cries how he becomes normal?”

Mother: “He will continue crying for very long with telling why we admonished and manhandled him. He will repeat the same thing till I take him in my arms and cajole him. After lot of fondling he will become normal and start playing. His hyperactivity becomes bit normal after giving him lot of caressing. But again he starts when his demands are not met.”

I took the following rubrics:

  1. MIND - MOROSE - chill, during
  2. MIND - OBSTINATE, headstrong - children
  3. MIND - DEFIANT
  4. MIND - ANGER - throwing things around
  5. MIND - ANGER - trifles; at
  6. MIND - CARRIED - desire to be carried - caressed; and

A dose of kreosote 30 lessened his hyperactivity and his appetite also improved.