Case Analysis: Finding the Bottom Line
Joe Kellerstein, DC, ND
Not long after my graduation from naturopathic college, and being rather lonely in practice, I was pleased one day when a lady stopped in, saying she had been referred by the chief of gynecology at a local hospital. I was taken by reverie: This obviously wise specialist must have heard of my great healing gifts! Then I gave my head a shake; this lady refused treatment and was told to go see the local “witch doctor.”
Finding the Case
Mrs. B. was suffering from severe abdominal pains, to the point of fainting pre-menstrually. In addition, she was having difficulty conceiving. Ultimately, her primary physician diagnosed endometriosis and offered treatment with a derivative of male hormone and laparoscopic surgery.
Determined not to blow my first case of endometriosis, I took a very complete case … Twenty pages later, I was totally confused and asked the lady to come back in two days, after I had researched her case to my satisfaction. I felt a headache coming on: There was no essence here; no marked mental symptoms.
The hours rolled by that evening. This was prior to computers, so I only had tedious repertorization sheets to work with. So many symptoms, so many remedies. Floating in a sea of impossible decision, I remembered a maxim – “if the repertorization is not clear, there is no case yet.”
These days, when I lecture on case analysis, I put it differently: “Never go shopping without a shopping list.” You know: When you’re hungry and in a supermarket looking for supper, the spirit of salivation takes over. Walking the aisles of empty calories and trans fats is more than we can bear. Everything looks good as we imagine devouring it. If, however, we first sit down and make out a list, we have found salvation, not salivation!
The Bottom Line
Early on in the Organon, Hahnemann crafts this idea beautifully. We must decide what is “undoubtedly diseased” in the patient. So, getting back to this lady’s case, I decided to cut through all the theory I had learned and get to the point: The worst, most consistent suffering was a cutting sensation across the abdomen that caused her to instantly fold forward and drop to the floor. This agony came in waves, and once on the floor, she would press a fist deep into her gut to counter the pain. Once I highlighted this in my mind, it was clear: colocynthis, the sea cucumber that caused violent, sharp, abdominal pains and forced its victims to bend double. Clinical cases abound highlighting this symptom in abdominal colic from whatever organic causation.
Study of the old masters in homeopathy teaches us to see the simple and straightforward in a sea of complexity and begin there. We allow nature to dictate emphasis and form.
Colocynthis ultimately cured the lady of both the pain and infertility. The medical doctor that referred her to me sent many more patients my way until his retirement a few years later.
Joe Kellerstein, DC, ND graduated as a chiropractor in 1980 and as a naturopath in 1984. He graduated with a specialty in homeopathy from the Canadian Academy for Homeopathy, and subsequently lectured there for two years. He also lectured in homeopathy for several years at the Canadian College of Naturopathic Medicine; for eight years at the Toronto School of Homeopathic Medicine; for two years at the British Institute for Homeopathy; and for the past five years, he has lectured for his own post-grad course in homeopathy, Homeopathy by the Book (homeopathybythebook.com). Kellerstein’s mission is the exploration of natural medicine in a holistic context, especially homeopathy and facilitating the experience of healing in clients.