Sadness (Bereavement) and Somatisation A Homeopathic remedy Case treatment Report Article by
Dr. Ashish Kumar Dixit
MD (Organon of Medicine, NIH, Kolkata)
A case of 60 years old female present with several physical symptoms developed after the death of her husband and some misfortune in her family is well responded through the use of Ignatia Amara.
Bereavement, Life Change Units (LCUs), Somatisation, Ignatia
Bereavement may be defined as “the state of being sad because a family member or friend has recently died” (Merriam Webster Dictionary) and Somatisation is a tendency to experience and communicate psychological distress in the form of somatic symptoms and to seek medical help for them. More commonly expressed, it is the generation of physical symptoms of a psychiatric condition such as anxiety. The term somatization was introduced by Wilhelm Stekel in 1924. It has no doubt that mental conditions affect physical well being and vice-versa. Death of intimate one has a very long-lasting impact on emotional as well as physical well being. Sometimes patient hide their emotional state only narrate the suffering of physical symptoms but these mental and physical symptoms have an unbroken relationship. The present case explores the relation of bereavement and somatization and resolution by homeopathic aid.
• O.P.D. Regd. No.: 88527
• Name of the Patient: Mrs. K. Age: 60 Sex: Female
• Religion: Muslim Address: Beldanga (W.B.) Police Station: Beldanga (W.B.)
• Date of examination/ Case taking: 04/March/2014
The patient was complaining of Palpitation, shortness of breath and oppression of chest which is aggravated at 4-5 A.M. and after disturbed sleep. She has a Cough which is bloody, offensive sputum and having no time modality, all complaints are aggravated by cold things and she can’t tolerate cold things in any form.
History of Present complaints:-
Complaints started in the 2002 year when her husband died and when his body was taken for the funeral she got unconscious and duration was of 30 minutes. After that incident, her complaints started gradually and since one year her complaints hamper her daily activities and also worse than before.
• She suffered from Typhoid disease 6 years back for which she was hospitalized for 11 days in hospital and took allopathic treatment.
• She was also having uterine tumor after the death of her husband, which was completely cured by homoeopathic medicine as she mentioned though the name of medicine and prescription was not there.
- Paternal: Father: Died from the Heart attack
- Maternal: Mother: Was suffering from Insanity
- Grand Mother: TB & Dyspnoea
- Others: Not Mentioned
- Addiction: Nothing
- Occupation: House job
- Marital Status: Married
- Relation with family members and in the field of occupation: Not good
- Habits and Hobbies: not such
- Dietetic Errors: irregular
- History of Vaccination: not taken
- Medications being taken regularly: nothing
- Living Environment: Damp house
- socioeconomic condition: Medium
Homeopathic Characteristics (Generalities):-
- General Modalities: Affected by both heat and cold.
- General Sensation and Complaints: Can’t bear the smell of smoke in any form
- Thermal reaction: Chilly patient
- Appetite: Diminished, only at 10 A.M. cannot tolerate hunger
- Craving / Desire: Meat, Sour, Sweet, Hot warm food
- Aversion: Spicy
- Thirst: Thirsty, all time she takes water through little at a time.
- Tongue: Imprint of the tongue, large tongue, white coated
- Taste no taste at all
- Bowel: Loose stool but not clear
- Urine: Burning in urine afterward, as if like fire
- Perspiration: excessive over the whole body, slightly offensive.
- Sleep: Nothing particular
- Dreams: Nothing particular
- Sexual function: Nothing particular
The patient was very much depressed and in grief after her husband died. She said that she didn’t want to live but because of her daughter she has to live. She has a daughter who is married but patient’s son in law humiliate her daughter and tortured her to say that one day he will leave her and will get married to his lover. Son in law also humiliates verbally to the patient. She is in constant brooding and in anxiety about her daughter. She said that she didn’t want to share her familial condition to anyone.
Diagnosis:- Chronic Bronchitis
The totality of Characteristic Symptoms:-
- Depression and grief after her husband died.
- Anxiety with fear
- Hiding tendency does not want to share
- Constantly brooding
- Can’t bear the smell of smoke in any form
- Cannot tolerate cold things, all complaints are aggravated.
- Craving / Desire: Meat, Sour, Sweet, Hot warm food
- Palpitation and shortness of breath, oppression of chest < 4-5 A.M., disturbed sleep
- Chilly patient
Repertorisation has been done from Kent’s repertory.
Prescription & Follow ups:-
Ignatia Amara 200/ 1 Dose
Rubrum 30/ 1 drachm, 1 glob x O.D. x 1 month
Follow up 04/April/2014:-
The patient is much better, cough improved, no hemoptysis but the shortness of breath is still sometimes troubling her. Her look appears somewhat better than before. On inquiry about her mental and familial condition, she said that she is feeling well though her son in law still humiliating her daughter. She is doing better in her daily activity. Placebo prescribed for next one month.
Follow up 08/May/2014:-
The patient is much better; a cough improved, palpitation and shortness of breath also better than before. Placebo prescribed for next one month.
Follow up 13/June/2014
The patient is much better, no new or old complaints appear, Placebo prescribed for next one month.
Follow up 20/July/2014
Patient having no complaints, sometimes feeling weakness otherwise well, Placebo prescribed for next two month.
Follow up 15/September/2014
No new complaints, She is feeling much better than before, but still, want to continue the medicine.
Justification of the prescription by reviewing the literature for Ignatia:
- As from the anamnesis of the patient she developed all her symptoms after the death of her husband
(Bad effects of grief- Allen)
- As she unconscious after the death of her husband.
(Effects of mortification, Affection of mind, Nervous affections; epilepsy; spasms; tetanus; convulsions- Herring’s Guiding)
(Kent’s Repertory first grade Medicine pg 10)
- Silent grief
(Kent’s Repertory first grade Medicine pg 51)
- Anxiety with fear
(Kent’s Repertory first grade Medicine pg 7)
- Unconsciousness after emotion
(Kent’s Repertory first grade Medicine pg 90)
- Unconsciousness transient (Kent’s Repertory first grade Medicine pg 91)
- Great grief after losing persons or objects very dear. Unhappy love with silent grief
- Cannot bear tobacco
(Materia Medica Pura)
- Avoids opening the mouth and speaking; laconic. (782, pg 706, Materia Medica Pura)
- A kind of the apathy in the whole body. (784, pg 706, Materia Medica Pura)
- These are the points which favoring the prescription of Ignatia Amara.
The above-mentioned case suggests the association of death of the spouse and afterward the increasing proneness to develop diseases. As we know from the §§210-230 Hahnemann clearly mentions that in every physical disease there is the alteration of mental state simultaneously and vice-versa. According to Holmes and his colleagues (1967, 1970) who gave social readjustment rating scale (SRRS), in which they consider life stress in terms of “life change units (LCU)”. For persons who had been exposed in recent months to stressful events that added up to an LCU score of 300 or above, these investigators found the risk of developing a major illness within the next two years to be very high, approximating 80 percent.
S. No. Life Event Value
- Death of Spouse 100
- Divorce 73
- Marital separation 65
- Jail Term 63
- Death of Close Family Member 63
- Personal Injury or Illness 53
- Marriage 50
- Fired at Work 47
- Marital Reconciliation 45
- Retirement 45
- Change in Health of Family 44
- Pregnancy 40
- Sex Difficulties 39
- Gain New Family Member 39
- Business Readjustment 39
- Change in Financial State 38
- Death of a Close Friend 37
- The trouble with In-Laws 29
- Spouse Begins or Stops work 26
- Begin or End School 26
- Change in Living conditions 25
- Revision of Personal Habits 24
- The trouble with Boss 23
- Change in Work Hours 20
- Change in Residence 20
- Change in Schools 20
- Change in Recreation 19
- Change in Church activities 19
- Change in Social Activities 18
- Change in Sleeping Habits 16
- Change in Eating Habits 15
- Vacation 13
- Christmas 12
- Minor Vacation of Law 11
Table 1: Stressors and Their Relative Value
In the paper “Effect of conjugal bereavement on mortality of the bereaved spouse in participants of the Renfrew/Paisley Study” by Carole L Hart et al (2007) studies report an increased risk of mortality in the bereaved spouse, compared with non‐bereaved spouses. However, it is not clear whether the increased risk is due to a direct effect of the shock and grief of the bereavement or due to the bereaved spouse’s own risk factors.
“The Effect of Widowhood on Mortality by the Causes of Death of Both Spouses” by Felix Elwert & Nicholas A. Christakis (2008) report says that “The increased likelihood for a recently widowed person to die—often called the “widowhood effect”—is one of the best-documented examples of the effect of social relations on health.”
Bereavement and its impact to develop somatization is a hidden relation which is emerging to establish in recent modern researchers. But for our homeopathic science it is not new, Hahnemann in several places in Organon discussed & established it. We as a physician can break this social disaster cycle by the intervention of homeopathic medicine at the proper time.
- Allen H.C.; Keynotes and Characteristics with Comparison of some of the Leading Remedies of the Materia Medica with Bowel Nosodes; Low price Edition; New Delhi; B. Jain Publishers (P) Ltd.;2002
- Coleman J.C.; Abnormal Psychology and Modern Life; Fifth Edition; California; Scott Foresman & Company (In India by D.B. Taraporevala Sons & Co. Pvt. Ltd., Bombay) 1984.
- Carole L Hart et al (2007); Effect of conjugal bereavement on mortality of the bereaved spouse in participants of the Renfrew/Paisley.
- Elwert F. & Christakis N. A. (2008); The Effect of Widowhood on Mortality by the Causes of Death of Both Spouses
- Hahnemann S.; Materia Medica Pura; Vol-1; 16th impression; Translated by R.E. Dudgeon; New Delhi; B. Jain Publishers(P)Ltd.; 2010
- Hahnemann S.; Organon The Art Of Healing; C. Wesselhoeft (Translator); Reprint Edition; New Delhi; B. Jain Publishers (P) ; 2007
- Hering C.; The Guiding symptoms Of Our Materia Medica Vol. VI; 7th Impression; New Delhi; B. Jain Publishers (P) Ltd.; 2010
- Kent J.T.; Repertory of Homoeopathic Materia Medica; Reprint edition; New Delhi; B. Jain Publishers (P) Ltd.; 2003
- http://www.merriam-webster.com/dictionary/bereavement retrieved on 21/09/2014
- http://en.wikipedia.org/wiki/Somatization retrieved on 21/09/2014
- Ignatia case