KNOWN TO UNKNOWN

1
KNOWN TO UNKNOWN PAINS-LOCATION-ACUTE DATA FROM
BOOKS ANALYSIS EVALUATION SYNTHESIS SYMPTOM?STAT
E?DISPOSITION MIASM FLY H/O PAST
H/O DIATHESIS FUNCTION STRUCTURE CONCEPTUAL
IMAGE ABSTRACTION SYMBOLISATION
2
FAMILY RANUNCULACEAE
REMEDIES BELONGING ARE CLEMATIS, ADONIS,
HEPATICA, PULSATILLA, RANUNCUNLUS, ACONITE,
ACTEAS, HELLEBORUS, STAPHISAGRIA, PAEONIA

• Most of these are herbs, soft stemmed, flowers
  are bisexual with reduced or modified petals and
  numerous stamen. Corolla often ten petaloid with
  showy sepals.
• They cause moderate to severe inflammation
  (Corrosive quality)
• An irritable, excitable, Nervous yet feeble and
  delicate temperament

Slide. 1
3

• 3. Physical
• Intense painful sensitivity with acute special
  senses leading to severe pain, Agg. by light
  noise, air, touch A/F Shock, Mental, Fright or
  senses are completely blunted
• Extreme Agg. by cold air, lt getting chilled,
  draft
• Catarrhal symptoms show the irritation of mucosa
  Serosa
• Inconstancy, wandering pains, fitful moods.
• lt change of weather, A/F Supp. of emotion
  discharges. lt change of life, puberty

Slide. 2
4

• Mental
• Extreme touchiness, irritable, easily vexed.
  Leading to weeping, quarreling, scolding, biting
  type of reactions.
• Extreme fearfulness timidity, fear of dark,
  ghost, fear of insanity fear of death.
• Sadness, hysteria Melancholy. Sad, hopeless,
  sits stares says or does nothing hysteria with
  self accusation. Sadness, depression gloom. As
  if a black cloud settled around her or Dark
  hopeless everything looks. Sad without cause.
  Indifference disinclined to meet agreeable
  company aversion to company with desire for
  solitude

Slide. 3
5
CIMICIFUGA
Dr. Allen E
SYMPTOMS Delirium with an inclination to run
over the subject on which he was reading ½ hr.
half intoxicated feeling with swimming of
head 2nd day Miserable dejected feeling in
afternoon depression and dullness Anxiety 3rd
day Feels grieved troubled with sighing, a
feeling of tremulous joy with mirthfulness,
playfulness
MENTAL STATE
DISPN
I E
Sadness Grief
Mania
Contd
6
SYMPTOMS Dr. Allen E I 1st
effect Mind clear Mind Dull Heavy
2nd day Not dispose to fix attention on any
subject.
MENTAL STATE
DISPN
I E
Sensation, Heavy black cloud had settled all over
her and enveloped her head so that all was
darkness and confusion, while at the same time it
weighed like lead on her head
Confused
I - Forgetful, Unable to find right word in
speaking Mind dull and heavy Indifferent,
taciturn, takes no interest in household matters
7
SYMPTOMS
MENTAL STATE
DISPN
I E
Sits Mopes in great sadness This may pass of
immediately or brought on lt Motion, Fear,
Excitement, Taking cold.
Miserable, Dejected feeling Gloominess Bowed
down with sorrow Great Melancholy With Suicidal
mood Apprehensive Anxious Weeping
Weeping Anxious ?
Moaning, Groaning Whining
8
SYMPTOMS
MENTAL STATE
DISPN
I E
Fear of death Fear those in house will kill
him Saw wires encaging him - Vision of rats
of strange objects Fear of becoming insane
Fear of riding in close carriage Full of fear
anguish, restlessness
Fearful
Fearful
9
SYMPTOMS
MENTAL STATE
DISPN
I E
Thinks she is going crazy Illusion of a mouse
running from under her chair Imagines strange
objects about bed, as rat sheep etc. Visions of
rats mice Tough wires encaged her
Illusion Delusion
Delirium with great headache Puerperium
Delirium with Nausea, retching, dilated pupils
10
SYMPTOMS
MENTAL STATE
DISPN
Mania following disappearance of neuralgia
Puerperal mania Answered question hurriedly and
evasively Declares she has been poisoned
Incessant talking, changing from 1 object to
another Would not answer at other times very
loquacious Feels grieved and troubled with
sighing, next day tremulous joy Suspicious of
everything would not take medicine if she new
it Mania before menses, alcoholic, tries to enjoy
herself Does know what is the matter with her
head, clutches it, screans
I E
Mania
11
SYMPTOMS
MENTAL STATE
DISPN
I E
Irritable The least things that goes wrong that
makes her angry Effects of Business failure,
embarrassment Disappointment of love, Fright,
Grief Nervous
Emotional
Hyper Sensitive
Restless Impatience can read only a few minutes
Must get up walk about, yet soon tires Desire
for solitude or to wonder from place to place
B Restlessness
Want of coherences
Incoherent
12
SYMPTOMS
MENTAL STATE
DISPN
I E
Hysteria Useful when there is sleeplessness,
nervousness, trembling, jerking on the side, lane
on nervous chills
Nervous Hysterical
Nervous
Nervous, Hysterical, Rheumatic subjects Nervous
fidgety excitable jerky
13
CIMICIFUGA (ACTEA RACEMOSA)
MENTAL STATE
EMOTIONAL STATE

• SADNESS, DESPONDENCY, DEJECTION, MENTAL
  DEPRESSION, GLOOM, MELANCHOLY
• SADNESS, ALTERNATING WITH CHEERFULNESS
• WEEPING TEARFUL MOOD
• Grief2
• Indifference
• Despair
• Company Av (Wants to be solitude)
• Suspicious ? Medicine Mistrustful
• Sensitive ? Noise, Labour during
• Touchy
• Suicidal disposition
• Irritable

14

• Fearful
• - Apprehension death
• - Abortion from fear, threat
• - Danger from impending , Death of
• Disease of
• - Incurable of being
• - Insanity
• - Loosing his reason
• - Climacteric during
• - Murder of being
• - Poisoned of being
• - Pregnancy during
• - Of rats
• - Injures himself, Fears to be left alone,
  least he should
• - Anxious
• Fright in night
• Anxiety, Climacteric, Menses during, Care
  worries full off.
• Death presentiment of homesick
• Hypochondriac

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REACTION
A/F BUSINESS FAILURE DISSAPOINTMENT OF
LOVE Anger Excitement Vexation
Anxiety Fright Emotional stress
PUERPERUM Disappearance of Neuralgia
lt Climacteric During menses Before menses
Menses suppression Pregnancy during
Exertion Company Lochia suppression
PUERPERUM Neuralgia Suppression Parturition
16
INTELLECTUAL

• Perception
• Dullness, Sluggishness
• Difficulty of thinking
• Comprehending
• Concentration difficult
• Memory
• Forgetful
• Weak, Dementia Epileptica
• Weak, expressing oneself for word
• Thinking
• Ideas abdunt, quick, rapid gush flow
• Writing difficulties in expressing ideas
  when
• Will, weakness
• Alter Perception thinking

17
DELUSION

• Animals of
• Persons are rats, mice, insects
• Rats are running under the chair
• Sheep

• About strange object, dark object figure sees
• ?
• Monster
• Arms are bound to her body
• CLOUDS, HEAVY BLACK, ENVELOPE HER
• ENCASED INWIRES
• INSANE SHE WILL BECOME
• Poisoned, he has been
• Home, away from, is must get there
• Images , Phantoms, sees

• DELIRIUM TREMENS
• Coma, Unconscious, Stupor

18

• Impatience
• Industrious
• Weeping type
• Hysterical type

A C T I O N
BEHAVIOUR

• Sleepless
• Dreams Unpleasant, of being trouble of ,
  or in a sad plight
• Headache

FUNCTIONING
19
B. THE MENTAL STATE
Sadness, Mental Dep., Gloom Alternating with
Cheerfulness Hyper Sensitivity, touchy Irritable
Fearful Anxiety Hysteria
A/F. Business failure Emotion stress
Disappointment in love Puerpereum, parturition
Disappearance of Neuralgia lt Climacteric,
Pregnancy lt D, B menses lt Menses Suppressed
Dullness, Sluggishness Ideas abundant Lack of
coherence Delusion Delirium
EMOTIONAL
INTELLECTUAL
REACTIONS

• Impatience
• Industrious
• Weeping type
• Hysterical type

? Thinking (Mania)
IMBALANCE
ACTIVITY
BEHAVIOUR
ACTION
EVIDENCE
INACTIVITY
FUNCTIONING
STATE NATURE CAUSE
? Difficulty in thinking (Depression)

• Sleepless
• Dreams Unpleasant, of being trouble of
  , or in a sad plight
• Headache

20

Psora Syco Tub Syphill
Hypersensitive 3 Anxious Fearful Impatience
Industrious Weepy3
Travels desire to Inconstancy
Changeable
21
Psora Syco Tub Syphill
A/F anger Disappointment love A/F
Puerpereum Disappearance of neuralgia A/F Grief
3 /Shock2
Cause
A/F Business failure - insanity
Excitement, emotion Vexation Anxiety Fright
MADNESS
22
Psora Syco Tub Syphill
Anger Irritable Grief Indifference to
everything Despair of life Despair of recovery
sadness
Mental state
Excitable 2 Rage, fury with headache Sadness
alternating with cheerful, Mirthfulness
E
Suicidal disposition
Company Av. To ltPresence of other
people Suspicious2, mistrusful2 (Medicine will
not taken)
sensitive?tonoise labour during
Mania with Lochia supress Insanity madness
23
Psora Syco Tub Syphill
E
Death presentiment of home sickness Hypochondriasi
s Hysteria Fainting, menses during Fear
Impending death of2, incurable, insanity, losing
her reason Diseases of impending Fear-
Apprehensive read Abortion from fear, threatened
Fear Murdered of being poisoned of
being Fear- Pregnancy Fear, Anxious,
Rats Anxiety lt During Climacteric lt During
Menses
Touchy
24
I
Psora Syco Tub Syphill
Dullness Sluggishness difficult of thinking,
Comprehensive Sluggish lt afternoon Conc. Diff.,
forgetful Writing difficult in expressing ideas
when Weak Memo weak, express one self Memo
Weak, for words
Ideas abundant Thought rapid, quick, rash flow
of (Mania)
Dementia epileptic form
Memory active Delirium tremors - Answer
abruptly - Fever during - during headache -
Loquacity - Pupil - dilated - Raging, raving
Unconsciousness coma, Parturition during
DELUSION
Will weakness of
25
Psora Syco Tub Syphill
Answer Av., loquacios at other times - Hastily
- Evasive - Irrelevantly - Refuses to answer
B
Business aversion to Business talk
Alcoholism Dipsomania

• Hurry, Haste
• Occupation in hurry
• Work
• Impatience
• Industries Mania for work
• Loquacity
• Loquacity alternating with silence
• Loq - rambling

Moaning Groaning whining
26
Psora Syco Tub
Syphill
B
Restlessness lt Forenoon afternoon
night midnight after
anxious Driving about Exertion
after feverish menses
menses during supp.
Playful Refuses to take medicine
Sigh3 lt during menses Sits still

• Speech
• - Doesnt finished sentence
• Lack of coherent speech
• hasty

Starting Startle sleep from
Talk, indisp to, D tobe silent Taciturn
Talk indisposed alternating with loquacity
Travel desire to Wander desire to
Weeping tearful mood spoken to when
27
Studying her PRESENTING COMPLAINTS under the
following format  

Confidence Loss of   H/O in
D3months Since June 1999 Persistent
since 2 yrs       AFFECT
CONATION
MoodNo Desire to do any work
AppearanceAnxious, Gloomy, Withdrawn
Depressed As if lost in
thoughts Anxiety about health H/o of
purchasing unwanted things

COGNITION Thinking Active, which Aggravates
 
SDB -1
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She is also complaining of a persistent ACHE
(Head), which is incapacitating. Past episode Rx
in 3 months with Prothiadine, now not responding.
Considering the above evidences we can conclude
that she is suffering from an AFFECTIVE
DISORDER.   In spite of her distress she is
continuing to attend her office, no symptoms
indicating effect on biological activity. This
should lead us to the diagnosis of DYSTHYMIC
DISORDER   Her symptom of UNWANTED PURCHASING in
the previous episode does point to?Hypomania
(Bipolar), but in absence of any other symptoms
then and now we can rule it out.
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CLASSIFICATION OF SYMPTOMS

• CAUSATIVE EMOTIONAL MODALITY WITH PHYSICAL EFFECT
  (1)

• AGGRAVATING MODALITIES-MENTAL (3)

• AGGRAVATING MODALITIES / Physical Particulars

A/F Shock Menopause lt Grief lt Contradiction
lt Thinking lt Fasting Anxiety Health
about Irritability Menses Before Dreams dead
off Craving Sweets Head lt Draft Sensation lt Sun

• Locations (2)

• Mental State

• Physical attributes (3)

• Dreams (2)

• Sensations Physical

• Attributes Mental / Physical

• Past History

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RESULT---Kali Carb , Natrum Carb, Pulsatilla,
Ignatia Sepia
These 2 symptoms are definitely highly
characteristic to be overlooked, and they are
used to enter the case through SPECIFIC
REFERENCE IN REPERTORY OR MATERIA MEDICA
Now when we look back at the case, the CAUSATIVE
EMOTIONAL MODALITY WITH PHYSICAL EFFECT (1)
Location Sensations Physical with AGGRAVATING
MODALITIES stand out prominently. The remedy
selected must cover this data. Attempting to
follow the reportorial approach LOOSES THE
SPECIFICITY of the above mentioned data
Reference to Kents Repertory for the above
identified key notes
31

• GENITALIA FEMALE MENSES suppressed, emotion
  form Cimic,
• Grief from Ign.
• 2. Boger Synoptic Key Pg. 168 CIMICIFUGA
  Region Head Vertex Worse
  suppressed emotions, Draft of air, Menstruation
  Compressive pains
• Boericke Pg. No. 203 CIMICIFUGA has a wide action
  upon the Cerebro Spinal Muscular system and
  Uterus and Ovaries
• Clarke Dictionary of MM Pg. No. 27 In all the
  mental symptoms there is want of natural
  coherence. thinks she is going crazy with
  headache on vertex.

32

• Kent over whelming, Sadness or gloominess. She
  is bowed down with sorrow (Psorinum, Puls) with
  headache there is marked sadness. One of the
  symptoms is quite descriptive of this sadness I
  have referred to sensation as if a black could
  had settled all over her. This is entirely the
  same time it weighted like Lead upon the head.
  This is entirely figurative. It can all be
  expressed in the word sadness. We will find
  melancholy, gloominess low spirited etc.,
  running all through our text, but the word
  Sadness is just as broad as any of them

Kent in his lecture on Pg. No. 36 goes on to
describe the effect of sudden emotion on the
uterus (Cessations of labour pain and Lochia)
33
MIND
Flow chart CIMICIFUGA

• Suspicious
• Puerperal mania
• Vision of rats
• Incessant talking
• Changing of subjects

MANIA
HYSTERICAL
HYSTERIA
A/F Fear / Fright Disappointed love Business
failure Emotional Excitement
DEJECTION
GLOOMY
DELICATE MELANCHOLIC
Grieved Trouble
CLOUD

• Fear something will happen
• Fear of death
• Dread of undertaking even ordinary work

NERVOUS APPREHENSIVE
34
UTERUS
TISSUE AFFINITIES
Weight
CEREBROSPINAL
ALTERNATING STATES REFLEX SYMPTOMS CHILLY lt M
B lt M-D ERETHISTIC HYPERAEMIA DEPRESSION PARALYS
IS NEURALGIA RHEUMATIC GOUTY
Labour Pains flying Referred neuralgic Pains to
head chest Lochia limbs Menses Abortion gt2
bending double with fainting spells
MOTOR NERVES
Sensation of heat/Hat, top would fly HEAD-VERTEX
OCCIPUT/EYES gt Pressure lt Lying CERVICAL SPINE
C1, C2 lt Lying lt Pressure HEART Angina Lungs
Pleurodynia Dry teasing cough lt Night lt Talking
RHEUMATISM SHARP bruised Lancinating electric
Shooting lt Night lt Cold Air Touch lt Warm Room gt
Open Air lt Menses clear
MS SYSTEM
35
CIMICIFUGA
Syco Tub
Childhood
M P
(Sustenance3)

• H/O. ? death of parents
• Neglected, Not care
• Env. Domination
• Suppressed emotions

Hypersensitivity Ambitious D for material
things Responsible Hardworking long struggle
Brave Anxious nervous, apprehensive
Fearfulness Hysterical
A/F Business failure Business
embarrassment
CHANELISATION
SOMATISATION
SUPPRESSION
A/F Grief Fright
Disappoint in love Shock
DEPRESSION
MANIA
Sensation of being caught/trapped /caged
Hysteria
Sensation as if black cloud enveloped her
CEREBRO SPINAL, MOTOR NERVES / (HEAD, CERVICAL
SPINE)?M.S. SYSTEM Heart Nerve Endocrine Females
Genital
Sensation Sharp Lancination Electrical
Radiating Wondering Shooting Stitching
A/F Puerpereum Lochia suppressed
Climacteric lt B. D. Menses lt Supp. Menses lt
D. Parturition lt D. Pregnancy
CHANGEABILITY
ALTERNATING SYMPTOMS