Case 1
Male patient, born 1969, retail salesman. Initial consultation: November 2001.
Main complaint: Severe anxiety, nervousness
The symptoms have worsened since the summer. He moved to a new town and started a new job. His new boss is a former soldier. He feels he cannot breathe. His oesophagus contracts spasmodically and he feels nauseous. His stools smell foul and putrid. (He suffers from chronic worm infestation). Physically he is tense and nervous. It is worse at weekends and in company. Worse when he travels by bus or car. Then he feels he must run away. He feels trapped, as if separate from everyone else.
Depersonalised. Rigid and panicky. Marked fear of death.
Over the past year his back has also felt stiff, to the left of the spine, up to the shoulder blade. Th5 is most affected. Sore and burning pains extending toward the lung. Pain worse from damp and cold.
At the age of nine he had a severe fever after a holiday in the Alps. High fever and delusions, especially in the evenings and at night. In his hallucinations he could no longer estimate distances and saw crowds and floods. He fell into other dimensions. Black holes. He woke up screaming. “I’m dying, I’m dying.” His parents tried to calm him, but he feared going to sleep. He had to be admitted for observation. Since then he has had anxieties and nightmares. For example, he is afraid that his mother will turn into a demon (she had PMS and was occasionally aggressive); afraid of being sucked up by the wind. Sometimes he also saw pleasant images, e.g. an old oak standing on a hill.
At home his parents often left him alone. At secondary school he frequently had panic attacks and became hypochondriacal. In late adolescence he then rebelled, squatted buildings, demonstrated against nuclear weapons etc., but he was not truly politically engaged. He has never felt comfortable in cities, prefers the peace of the countryside. Depression and suicidal thoughts, many images of suicide, often lonely.
Six years ago a relationship broke down; at that time he went abroad to do a carpentry apprenticeship. His girlfriend was pregnant by him and felt abandoned. She blamed him and for three years he was not allowed to see his newborn son. The blame affected his self-confidence strongly; he felt powerless and angry. He was lonely.
Sleep is good.
He enjoys sport and goes climbing in the mountains.
Physically worse in winter.
Cravings: bread, mature cheese, tea, bell peppers, meat, eggs, Dutch specialties, herring.
Aversion: fat.
Sweats very little; is neither particularly thirsty nor unthirsty.
Previously he had taken:
Nat-m: Depression >
Ipec: Nausea >
Cina: Worms >
Staph: Anxiety <
XXXX: euphoric for a while
Rhus-t: Back complaints >, Anxiety <
All remedies were prescribed in potencies 30 – 200; single doses.
I did not repertorise the case because I had, among other reasons, already thought of XXXX before he mentioned it. XXXX was Aconit and I prescribed a single dose of 10M.
Follow up:
Follow-up prescription after four weeks:
The anxieties are gone; the cramps much better, the oesophagus also feels better. Breathing is not so constricted. He no longer has bad premonitions about the future. Feels internally calm and relaxed. Less tense, but still feels slight burning pains near Th5. Bowel movements are better, no more worms. More energy. Can express his anger better. Once he fainted in the shop where he works. Had some clairvoyant dreams. Feels generally better.
He was very satisfied with my prescription of Aconit. Not only because the remedy helped him so well, but also because last summer he had a dream in which, in the mountains where he planned to spend his holiday, he encountered an important plant. The first plant to come into his awareness there was indeed Aconit.
Eight months later:
Because of a slight relapse he on his own initiative took Aconit 200 and it helped quite well. At my suggestion he took another 10M, which helped very well. Additionally I would like to note here that the patient confided to me that he was probably an Aconit case from birth, because he had almost suffocated on his umbilical cord during birth.
The reason I want to share this case here are my impressions of this patient, which were important in addition to the obvious symptoms. During the initial consultation the man made a gentle, almost compliant impression. But only almost; he was compliant up to a certain point. Similar to Pulsatilla, but with more “substance”. He chose his words deliberately so that he could report his symptoms to me as clearly and distinctly as possible. He spoke evenly, a little slowly and somewhat circumstantially. He was by no means impulsive or direct. He gave the impression of an introverted person who had decided that he needed help and therefore was opening up. At the same time I noticed that he was watchful and followed me attentively to see whether I would reject him in any way. I had to proceed gently so that he could open up as much as possible. One could almost feel his vulnerability and sensitivity when looking at him. Occasionally he looked at me with wide eyes to see if I was following his account attentively.
This impression nicely demonstrates the “difficulty concentrating”, the “shyness and embarrassment” and possibly also the “mistrust” of Aconit in a very likely “constitutional case” (whatever the term “constitutional” may mean).
Case 2
Male patient, born 1963. Initial consultation in 1994.
In this case there is no main complaint. The man comes to me to find out whether homeopathy can generally improve his health.
I will record his history here in the order in which the patient reported it. It is somewhat confused.
Since January 1993 he has been taking Leponex (an antipsychotic) and therefore often needs to sleep. From 1990 to 1993 he took imipramine (an antidepressant). The reason was his “delusions”. When the symptoms began he worked for the Ministry of Justice and felt watched by the police. He believed they were observing him from his neighbours’ houses. He thought he would be suspected of stealing documents and that the air force would be measuring his IQ. He had studied economics but dropped out. In his youth there had been incidents which made him suspicious and guilty. Since 1989 he has been under psychiatric care.
In general he feels worse in the evenings. He goes to bed late and wakes late. Once he felt there were other people in his bedroom. He has bought arsenic for rats. He has difficulty concentrating and his “actions do not match his thoughts”. When he was about 20 he thought something was wrong with his head because he had many problems with his final exams. He currently has some structure in his life; he still hears voices and thoughts in his head and needs a laxative to have a bowel movement once a day.
He likes Indian food, well-spiced dishes, sweets, chocolate, ice cream and is thirsty. He likes spring and autumn, music and forests. He has never had an intimate relationship; he likes his freedom. He sleeps well and always on his back. In his dreams he is often pursued. At 18 he once dreamed of sleeping in a coffin. He has attempted suicide twice (throwing himself in front of a train). Since taking Leponex he has had drooling in his sleep. He bites his nails (always). As a child he was always afraid his parents might die. His father was an officer in the navy. About ten years ago he masturbated regularly and a lot. Work is an important issue in his family. He has always found it difficult to express his anger and as a child he feared burglars and the dark. He had exam anxiety; currently he often wonders whether he is doing the right thing. His head feels empty.
The initial consultation was therefore obviously confused and incomplete. I did not want to pressure him in conversation because he seemed very fragile. He did his best to answer all questions cautiously. The theme of guilt seemed important.
After one dose of Kalium bromatum (C30) he was less hurried and could concentrate somewhat better. Generally he felt warmer. He continued to have paranoid dreams and heard voices. He also reported short manic episodes and a compulsion to always win at tennis. For many years he has suffered from diarrhoea and needs to use the toilet 6–8 times a day (contradictory to what he said in the first interview).
Over the course of half a year he took Kalium bromatum twice and each time reported feeling calmer inside. Once we tried Bromium, but without success. Afterwards he felt trapped for a while.
Six years later he returned.
He reports that he tends to procrastinate decisions and often stays in bed until 11 o’clock.
Cravings herring (2), salt and everything already mentioned above.
Aversion to vinegar and fat.
If he drinks beer he gets nightmares, e.g. of being eaten by crocodiles or lions. Generally he feels better when he is among people. He still hears voices and is sometimes paranoid. The diarrhoea has not changed. The nail-biting is unchanged. Difficulty concentrating.
The diarrhoea is worse in the morning and he has to go to the toilet straight after getting up. His stools often smell of rotten eggs.
Analysis:
This time I looked in the repertory for: “Rectum – Diarrhoea – on getting up – agg.” and the rubric directly below: “and when walking about”. (According to Hahnemann’s instructions). Natrium sulphuricum is bolded in both rubrics. For me that was only an indication. After I found matches between the general personality traits and our materia medica (see “Homeopathy in Reflexive Perspective”), the remedy choice became more probable. I theorised that the “paranoid” fit into the “possibly hostile” columns and rows of the periodic table: columns 8 and 16 and row 6. And possibly into the “vulnerable” columns and rows: columns 2, 4 and 12 and row 2. Since the sulphur component of Nat-s. stands in column 16, I understood that as a rather vague confirmation of the symptoms. Other aspects of the case also fitted Nat-s and I prescribed the remedy in 1M, single dose.
Follow up:
Two months later: The diarrhoea initially became worse, but then disappeared completely, which he was very pleased about. He was able to organise his life better and began volunteering. Very importantly, he no longer had nightmares. Also no more delusions and no more paranoia.
When the diarrhoea returned in mild form six months later, he took Nat-s again. On his psychiatrist’s advice he continued to take Leponex, which had not helped the delusions so far.
Currently – almost a year later – he is still well, without nightmares and without delusions.
The question that arises here is whether one can derive or transfer psychiatric “diagnoses” from the mood symptoms of the drug pictures we know.
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Category: Remedy
Keywords: Anxiety, nervousness, Aconite, delusions, paranoia, Natrium sulphuricum
