One expression he used very often was "Damn angry".I was sure this expression must have a lot to do with his state .The word `damn' is related to `curse' `condemn' `hatefulness' (damnable).

The important traits of the patient were :-

• Malice-revengeful with excessive thoughts of revenge.
• Excitable
• Very sensitive, offended easily.
• Hatred
• Faint hearted
• Fancies exaltation of
• Theorising-Planning
• Industrious
• Serious
• Sensitivity to coffee.

When analysing and evaluating the case, I was reflecting on these traits and searching for a remedy which could produce this kind of a highly sensitive, excitable and malicious state. I got convinced about the remedy Angustura Vera after I referred and studied the rubric `Hatred has bitter feeling for slight offense (` C/f Embittered - offenses from slight') Let us understand the meaning of this rubric.

1. Hatred - Hatred means having a strong dislike, bear malice and have an ill-will for someone.
2. Bitter - means very virulent, biting harsh feelings.
3. Slight - means rather flimsy, small amount, unimportant, trifling.
4. Offense - Aggressive action.

So this rubric means, to have hatred i.e. malice and very strong dislike and ill-will and to have very virulent, biting harsh feelings for unimportant, trivial, negligible aggressive act. These Angustura patients are highly sensitive to any offenses. Over a period of time, they develop a delusion as if people are on purpose offending them, humiliating them and persecuting them. It seems as if they are reacting to a situation where they are persistently and chronically put down and also the feeling of being `smalled' in presence of others under such circumstances, he suffers this intense humiliation with a totally helpless feeling because of his cowardice and also his vulnerable small status. He reacts with intensely bitter feelings for this offense and develops a state of hatred and desire for malice to avenge this humiliation. The only way he can do this is by theorising in his mind a favourable and inverse situation where he can equally put his offenders down. The ambitious and industrious nature of these Augustura patients stems from the hope and desire to become big so that they are no more vulnerable to such indignation or to enable them to avenge the insults. Somehow the Angustura state has lot to do with coffee. In this particular case, an extreme sensitivity to coffee was more marked than craving for coffee.

The modality of the chill in malaria was 3 PM. Also,Clarke has compared the excitability of Angustura with Nux Vomica. It was interesting to note that Angustura belongs to the Ruta family and is related to injuries. Clarke has described the pusillanimity and want of self-confidence in Angustura.

The dictionary meaning of pusillanimous is mean spirited and also faint-hearted. It was strange that both the meanings seemed to apply to this case.

The important rubric showing various aspects of Angustura are as follows:-

1. Hatred, bitter feelings for slight offenses.
2. Embittered, exasperated offenses from slight.
3. Ailments, insults offenses from (Complete repertory)
4. Offended easily (My suggestion is to make Angustura in bold marks in this rubric and put Embittered from slight offense as a very important cross reference to this rubric)
5. Jesting, joke can not take a

These rubrics give us the idea of the sensitivity and the bitter feelings of Angustura.

The rubrics showing the timidity and pusillanimity are :-

• Startled, sleep during
• Fear of death from heart attack in dyspepsia
• Fear, death of, heart symptoms during
• Anxiety, paroxysms, attacks of
• Anxiety with weakness
• Cowardice
• Frightened easily, trifles at
• Anxiety in bed, wake up as if he would never
• Delusions, imaginations, fainting, faintness of

The rubrics showing activity of the mind are:

• Activity, increased excessively
• Delusion, fancy of
• Memory active
• Plans, making many
• Thoughts, Clearness of
• Thoughts, persistent rapid, quick, rush, flow of, wandering thoughts
  Theorising

The rubrics, I suggest for further addition in the repertory are:-

• Thoughts, malicious
• Ailments, injury
• Head, Pain, anger, vexation from
• Ailments, indignation
• Offended easily (My suggestion is to make Angustura in bold marks in this rubric and put embittered from slight offense as a very important cross reference to this rubric)

Follow up :

He was given one dose of Angustura 200 on 15 june 1990. He responded immediately to the dose and reported considerable amelioration in his headaches within one week of the remedy. In the second week after the remedy, he came down with an attack of intermittent fever during this fever which lasted for 2 weeks, he was put on placebo. The blood smears did not show malaria parasites. This whole episode was much less intense compared to his previous attacks of Malaria when he suffered for almost 6 months with frequent chills and extreme weakness. I have followed him up from 1990 to 1995 and he has reported total amelioration in his mental emotional state and no recurrence of headaches or malaria. It was exciting to see a single dose of the remedy produce such a long lasting cure.

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