The effects of Morphine fear and pain , along with Hospital Disorientation caused by sudden emergencies, disturbed routines and rhythms, can contribute to a serious and lasting break with reality.
Please have a look at a few excerpts from an I.C.U. case, below: (most relevant parts in bold)
As I approached the door, I was greeted by two figures. One shot his first bullet at point blank range.
Time slowed down for what seemed to be a life time.
Time slowed down for what seemed to be a life time.
It was at that point I accepted death, as I calmly lay on the floor. To accept death calmly in the final moment and then not to die changes everything for ever. I can not tell you how powerful that moment of utter faith and acceptance is, so much so that a part of me was sad to return to this world when I awoke in the hospital bed, it seemed like a part of me was still somewhere else, left behind somewhere
For the next four days as I was unconscious in a hospital bed in ICU.
In my head I was awake, and somewhere different, in a different place, the time scale was the same as I spent four full long days there, but it was not this dimension. When I awoke I could see a big blue spiders web being projected onto the ceiling with a small red dot in the middle, this red dot was the bullet inside of me.
I woke again, this time in a function room of a hotel, It was a large hall room, red in color and cheaply decorated with large windows from floor to ceiling, draped with long, pinkish to red curtains. My brother, and his girlfriend sat beside my bed, we chatted for a while.
Lying on the bed In the same room a light was turned on, I could make out that I was in an underground cave system, an arch in the rock led to another room were nurses stood, eyes fixed on there laptops.
After that I started to wake up and was slowly weened off the morphine.
The points i'v included from the account above correspond very closely to the experience my husband went through earlier this year following a serious R.T.A. Drifting in an out of consciousness on the borderland of the bardo of death, under the influence of morphine the soul experiences great confusion of time and place. The distinction beween life and death is horribly blurred. "Am I alive, dying or am I in hell ... or some other horribly wierd dimension?"
I have been helping him with homeopathy ever since. Every day, every remedy a minute step ... but always stepping in the right direction. My first really difficult descision was regrading the Homeopathic remedy, Morphine.
Morphine itself is in Dr Sankaran's acute miasm - its a situation of 'do' or 'die'.
In the weeks following ICU Psychosis the situation can develop into a sitaution where the patient is trying to keep in control in the midst of chaos. The feeling is that "I'm alive, I'm ALIVE!!", it alternates with the question "Will I ever be well again? Will I ever be ME again?". This gives the depth of post traumatic fear. This is the cancer miasm; a battle we might not win.
Opium is the opiate remedy from the Cancer Miasm. Opium covers many ICU Psychosis rubrics, such as dreams of war and black forms, confusion of identity, and delusions of dying, or being dead, spectres and ludicrous situations.
Rubrics: COMA/ DREAM as if; + DELUSIONS - dead - he himself was:
Op anh cann-i anac Oena stram apis cypra-eg Lach phos ars.
However I would like to argue that Carcinosin is a good starting point.
Its a choice beween the closest similimum (the original drug potentised) or a remedy with a more antidotal relationship to the current symptoms. Do we want the patient to re-experience the ICU Horrors (Op.) or to gently ease them away (Carc)?
Another difficulty eating at the back of my mind, was that I was wondering if the feeling of being dead merely a product of the Morphine, just a drug induced delusion or was it a true perception of the situation? We both actually believe that it was not a Morphine delusion, it was the truth.
I started with Opium 1M, given on the rubrics below, but was rewarded with the effect of a proving of the remedy!
- MIND - DANGER - no sense of danger; has
- MIND - DEATH - contempt of
- MIND - DEATH - desires
- MIND - DEATH - sensation of
- MIND - DEATH - thoughts of
- MIND - ESCAPE - attempt to, runs into the street.
Why was Carcinosin more effective than Opium in this period of post ICU recovery? I'm still pondering upon this question. A strong feature of the first month was the need to separate the ICU delerium from reality. To put the confused impressions into some sort of order on the timeline. We know the theme of warlike violence is present in the Paperveraceae along with the sense of being pusued and the desire to get away from the danger. When I gave Opium 1M it only seemed to bring these symptoms into consciousness, rather than healing them. Little was gained. If anything, Opium seemed to have the effect of a proving, bringing back the ICU confusion and fears and the recurrent nightmares of thousands of black spiders exploding over the walls. There was some improvement but on the whole, I felt stumped.
Subsequent doses of Staphisagria and Arg met, gave more relief than Opium.
The common fear is that recovery will be impossible, and that life will be but a shadow of what it was before ... a life of unremitting suffering and handicaps, leading only to an early grave. This kind of fear can produce what we could call a "heroic" reaction. The person takes every day as a desparate challenge - which is exacly how Dr. Rajan describes the cancer miasm, i.e. as "a task beyond my limits".
I grabbed the opportunity to speak to several accident victims and there was a common set of features shared by all these folk, who can be very difficult to live with to say the least. Some of these common symptoms include great agitation, anxiety and touchiness. Obstinacy in general is a symptom which has also been observed. There is also aggression, anger and destructiveness.
Vithoulkas says, of Carcinosin, "The vulnerability manifests in an extreme sensitivity to mental, emotional or physical pain and, as a consequence, they cannot stand any reprimand". These people cannot brook any interference - the slightest reprimand or provocation produces a violent reaction, verbal or physical. They are totally inconsiderate of the feelings of others. Often they will be brutal and rude in their behaviour towards their relatives or friends, but kind toward strangers.
Lets sum up so far, in terms of Carcinosin Rubrics:
- MIND - ADMONITION - agg. - kindly; even
- MIND - AILMENTS FROM - anger - indignation; with
- MIND - AILMENTS FROM - anger - silent grief; with
- MIND - AILMENTS FROM - anxiety - prolonged; from
- MIND - AILMENTS FROM - fright - long lasting
- MIND - AILMENTS FROM - fright - severe
- MIND - AILMENTS FROM - rudeness of others
- MIND - AILMENTS FROM - scorned; being
The real essence of the state, in this layered case, emerged quite quickly as the euphoric realease of stress from the Carcinosin began to fade. This set of rubrics describes the emerging state, as it arose, almost perfectly ....
- ADMONITION, agg. (added lyc to Radar rubric)
- ANGER - trifles; at
- ANGER - vexations; about former
- ABRUPT - affectionate; rough yet
Result: Lyc, Nat-m, Nux-v, Sep.
Lycopodium, like Carcinosin also has: 'AILMENTS FROM - domination, long time; for'. It also has many anxieties and fears.
I prescribed Lycopodium LM1. One dose, LM 1 was enough to provoke catharsis (LM 1 seems to work well when the stress is close to the surface).
One imortant aspect of Lycopodium came close to my Husbands situation, the feeling of being helpless to prevent any of the painful and very, very scary hospital procedures. In ICU new terrors have to be faced from day to day as our life hangs in the balance. Even though we know with our intellect that these procedures might save our life, our subcsonscious mind compares the situation to imprisonment and the most extreme forms of torture. The feeling is of being small and vulnerable, to a heightened and intense degree.
Lycopodium was once a tall, proud tree-like plant, towering into the prehistoric skies, over millenia, impoverishment of its habitat has forced it to evolve into a tiny little club moss. It is now a small and vulnerable little plant! This is the situation we are faced with in ICU. Our freedom and power are reduced to nothing. We feel that we are but a shadow of our normal self. Our normal, powerful, identity is in ruins and destroyed. The quality of our life, and hence the will to live depends on the ability to be free and to act without hinderance. Hence the patient, during recovery rebells angaints any hinderance.
The rubric describing is this is, Rebels againts poultice.
The rubric includes a set of remedies that show this tendency to varying degrees. The list includes:
borx bry Calc carb-v Cham lyc merc mur-ac nit-ac nux-v phos puls rhus-t sep spig staph Sulph.
One might argue that the core Lycopodium state was there all along. In fact it must have been there, but obscured and buried under an array of other problems the one wouldn't immediately associate with Lycopodium, the little club moss!
One valuable lesson I am taking away from this is that I can re-assert with absolute confidence that a naive 'Genus Epidemicus' approach (Nat-m for grief, Ignatia for shock, Opium for fear) is the least reliable way of determining the prescription.