My sexual energy is usually pretty high. I haven't been sexually active in the past year.

I have abdominal cramping (3)... a lot of cramping (2) and bloating (2) then diarrhea (3). I take Immodium. The diarrhea comes about once every two weeks. I also have gas (2) and a burning pain in my abdomen (2). I tend to be blated a lot (2).What if I feel sick? People are gonna ask me, 'What's wrong?' When the cramps start, I worry, 'Oh, what if I get diarrhea now?' I don't want to be bothered with the colitis."

Fears: "What if I'm somewhere without a bathroom? (3).

Keeping my job (2). I was surprised to hear that my employers are afraid I might leave. I'm just trying to be the good daughter who wants to please (3)."

Temperature: "I'm always cold (2), especially my hands, feet and nose."

Sleep- Not good past four mos. I can wake at two or three a.m. occasionally. Mostly not a restful sleep.

"I worry a lot about the future (2). Will I meet someone, marry, be able to have kids, have enough money? I asked for a raise last year. My employers argued about what to pay me. I was afraid I wasn't doing a good enough job. I used to stew a lot. I think about something a lot before I act (2)... about other people and what they thought of me... do they like me? Am I making a good impression? I'm not too excited about much of anything (2)."

Foods: Desires microwaved popcorn (3). Aversion to sauerkraut (2)

Uses Retin A and antibacterial wash for facial acne

Now, take a few minutes to think about Laurel. Before looking in your repertory or thinking of remedies, ask yourself what is unique about her. Then list up to ten symptoms that are most prominent for her on a physical, mental, and emotional level. Then use your repertory to choose four to six rubrics which really fit Laurel well. Select several possibilities for remedies. Then, if you have not found a remedy you feel really good about, consult a materia medica to see which of the remedies fits Laurel most closely. Then turn to page ____ for the case analysis and the rest of the article.

Case l: Laurel

We prescribed Colocynthis (Bitter cucumber) 200C for Laurel based on her comment"stress goes straight to my stomach", the combination of gastrointestinal and gynecologic pain, her inability to confront others similar to Staphysagria (which is complementary to Colocynthis), and her dysmenorrhea during which time she was doubled over in pain which was better from curling up on her side and her cramping, bloating, and diarrhea. We based my prescription more on her physical symptoms, though we understood that Colocynthis fit her mental state as well.

12/21/93

"I've actually been feeling a lot better with the colitis. Only five or six days of discomfort. I'm 70% better. I haven't felt as anxious. My stools are regular... one to two times a day. I've had no diarrhea since last visit. I can still lose patience easily. It's still hard to get motivated. My bloating is not as frequent. I'm not as bogged down so much anymore about all the "what if's?"

We assessed that Colocynthis was correct and asked Laurel to return in two months.

Method of casetaking and case analysis of Rajan Sankaran and colleagues:

It is at this time that we left for India. Before continuing with Laurel's case we wish to summarize for you some of what we learned about casetaking and understanding the patient from our Indian teachers.

Casetaking:

1. Observation of the patient
2. LISTEN to the patient. Say as little as possible. Ask only the necessary questions to confirm the remedy.
3. DO NOT OPEN YOUR REPERTORY/ BOOKS WHILE THE PATIENT IS TELLING HIS OR HER STORY.
4. MAKE SURE YOU REALLY UNDERSTAND THE PATIENT. It is not lots of data that will help you find the remedy, it is understanding the patient. Do not hesitate to ask "why?", or say "I don't understand what you mean" or "Please give me an example" or "How did that make you feel?" It is fine for you to seem "ignorant" in order to fully understand the patient.
5. We have found the most important question in the casetaking to be: "If I were to ask you 'WHAT IS YOUR CORE ISSUE; THE THEME OR CHALLENGE THAT HAS RUN THROUGH YOUR ENTIRE LIFE, what would that be?" (This is our adaptation and not something which we were taught in Bombay.)
6. Other questions we now ask:
   • What has been the most difficult thing for you in your life?
   • Which of your parents are you most like?.... Tell us about him or her.
   • What was the hardest thing for you in your childhood?
   • What is most important to you in your life
   • If a person tells you about their hobby or passion or interest, ask why they like it/ what it means to them.
   • If a person tells you she is afraid of something, try to create that imaginary situation in the consulation and ask how she feels. Eg: "Imagine a snake were five feet away from you right now". The same is true if someone tells you criticism is difficult for him. You can say, "Imagine someone said _____ to you. How would that make you feel?"
7. Don't be satisfied with answers like "I'm afraid of failure" or "I feel abandoned". You need to understand WHY she feels this way, what it means to her.
8. Be sure to ask about dreams. If the person says, "I never remember my dreams, prod a bit." Ask, "Have you ever remembered a dream?" or "Do you remember a dream from your childhood?" or "Tell me about just one dream.... any dream." If the dream has an obvious theme, you may want to ask, "Is this a theme which has been an issue in your life as well?"
9. If necessary, get more information from family members, friends, etc.