| Sonia S, a tall, willowy Latina woman with large
deep eyes and a beautiful wide smile, came to see me complaining
of “bursitis, joint pain, tiredness. Joint pain began in graduate
school when I ran into an old boyfriend on vacation.”
She continues, “My foot pain started then, and shortly thereafter
my hip pain, and I have had it ever since. Wet weather aggravates
it, and when I travel for work on airplanes. First thing in the
morning it hurts, then it begins again in the afternoon around 2
or 3 pm.” She is now 30 and the joint pain began when she
was 25.
She rarely remembers dreams, none are recurrent. She weeps easily
premenstrually but not the rest of the time. Her fears vary, usually
worrying about day-to-day issues at work. Others see her as a perfectionist,
controlling at times, and as someone who worries too much. She says
she gets stressed easily, with her biggest stress work-related (finding
work she likes; she currently works as a consultant.) She gets angry
when stressed. She also gets angry when things don’t go as
she expected them to. She gets jealous when her husband spends a
lot of time talking to his old girlfriend, or to her best friend.
She describes herself as a child as being happy, active, and very
social. If she had time off from work, she would like to travel,
visit a city she has never been to before and go dancing. What she
would like to change about herself: would like to be more easy-going
while still having energy and excitement.
Her only medication is birth control pills. She gets a mid-cycle
vaginal discharge that is clear, thick and sometimes white.
She dislikes beets and says of her diet only, “I could eat
more vegetables.” She likes room temperature drinks and sleeps
from 10-11 pm to 6-7 am. She gets canker sores in her mouth, and
her jaw sometimes cracks.
When I met her, I was struck by how beautiful, smiling, friendly
and outgoing this woman was. I asked her first to give me more details
of her joint pain: she said when she went out to San Diego and ran
into her old boyfriend, her right ankle hurt, then her left knee
and hip (possibly from favoring her right ankle, she said); then
it spread to the left ankle and right knee and hip. She has been
to a physical therapist to strengthen her leg muscles but still
lacks range of motion in her ankles. She has been diagnosed with
bursitis of the hip and has been to an acupuncturist. Acupuncture
left her feeling calmer and more relaxed but did not help her joint
pain.
The joints feel worse in damp weather and worse when she first
gets up in the morning, then better as she starts to move around,
then worse towards the end of her workday because she has been zooming
around all day trying to get things done. They are worse when she
flies especially when she goes to Europe. She can’t bear sitting
still and tries to keep walking up and down the aisles. It’s
hard for her when the Fasten Seatbelt sign goes on and she has to
sit down, cramped in the small seat. Traveling is also difficult
when she has to carry heavy luggage because she gets worn out. Stretching
helps, but exercising too much makes the joint pain worse. A hot
bath makes it feel better.
Once she seemed comfortable in the interview, I asked her more
about what happened in San Diego. She said that she had a boyfriend
from the age of 16 to 21 while living here in the Boston area, then
she broke up with him. When she was 25 she went to visit a friend
in California and by an unbelievable coincidence, this ex-boyfriend
turned out to be the roommate of the friend she was visiting. It
was an uncomfortable situation, in fact the young man was quite
nasty, “agitated and not nice.” He mentioned that he
had a gun.
She became convinced that he would come back to Boston, find her
and kill her. (Upon questioning, though, she admitted that he had
not actually made any threats.) She was so afraid that he would
kill her that she moved to an unlisted address, using a PO box for
forwarding, and had an unlisted phone number which she gave only
to her family and a few close friends. When she got married two
years ago, she would not allow her wedding announcement to be published
in the paper, because she did not want him to know where she was
or what her married name was. Even though this incident happened
five years ago and she is now married, they still have an unlisted
number.
----------------------------
ANSWER
This is a Rhus tox case. While taking the case, of course I kept
thinking of Rhus tox because of all the typical modalities of the
joint pain. However, I usually think of Rhus tox as an acute remedy,
not as a chronic remedy that can cover the totality of the client’s
case including mental-emotional symptoms. When she got to the part
about believing her ex-boyfriend wanted to kill her, that confirmed
Rhus tox on all levels – it is the classic Rhus tox delusion
about being murdered. It was clearly a delusion on her part, as
it was influencing her behavior even years later, to the extent
that she still had an unlisted phone number. The client did very
well on Rhus tox, which cleared up all her joint pains. She referred
her husband for homeopathy a
Characteristic symptoms:
bursitis, joint pain
in lower extremities
< wet weather
< first thing in the morning
< 2-3 pm
> moving around
< sitting still
< exertion (luggage)
> hot bath
> stretching but < too much exercise
controlling, perfectionist
gets angry when things don’t go as expected
other symptoms
easy weeping premenstrually
worries excessively, work-related (an argument could be made that
this is a common symptom and therefore not characteristic to her)
canker sores
jaw cracks
believes ex-boyfriend wants to kill her even though he did not say
so
Other possible themes: restlessness, overgrowth/excess
Rubrics could include (there are many variations)
K1047, Extremities, pain, joints
morning
damp cold weather
exertion, after
K1048, Extremities, pain, joints
warmth amel.
K1063, Extremities, pain, lower extremities
morning on rising
move, beginning to
K1066 Extremities, pain, lower extremities
sitting, while
weather, wet
K1191, Extremities, stiffness
morning, bed, in
rising, after
afternoon
rising, on
K1192, Extremities, stiffness, joints
morning
on rising
sitting, while
K1193, Extremities, stiffness, lower limbs
morning
These subrubrics are small and so could be combined
K45, Mind, fear, happen, something will
(or better yet in Synthesis, Mind, fear, control, of losing)
K16, Mind, conscientious about trifles (= perfectionist)
K29 Mind, delusions, murdered, he will be
K94 Mind, weeping, menses, before
K397, Mouth, aphthae (= canker sores)
K357 Face, cracking in jaw, when chewing (she didn’t actually
say when chewing, but that’s the only repertory option for
jaw cracking)
Rhus tox not only covers the joint pains and the delusion, it also
covers the cracking in the jaw. The only other remedy we might think
of for her is Phosphorus, which covers her outgoing nature and her
love of dancing and travel. She may have a Phosphorus consitution
underlying the Rhus tox layer caused by meeting the ex-boyfriend,
however Phosphorus does not cover the joint pains which are so characteristic
of Rhus tox.
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