As a new homeopathic practitioner, this case taught me the importance of using judgement when dissecting symptoms and deciding on the prominent ones.
The name of this patient has been changed.
1st consultation: 13 March 2010
Tara, aged 19 wanted help for her frequent episodes of sleep-talking, which happened almost several times a week. She tended to talk about very random things in her sleep. Basically, there was no recurring theme.
She had a lot of acne on her face, back and behind the ears. On her back, the acne left blackish-brown marks. She had a tendency to develop large pustules on the face. The eruptions aggravated during stressful times, such as before exams, etc.
She complained of profuse perspiration, especially in the axilla. Her feet and palms also became very sweaty. The perspiration left a yellowish stain on her clothes. There was also a slight odour.
Tara had also observed that she generally got a pain in the right side of her head when in the sun. She preferred cool weather.
She felt very thirsty but didn’t really like water. She preferred drinking sweet or flavoured drinks. Her appetite was good. She did not have any particular food likings or aversions.
Sleep was also sound and she felt refreshed in the morning.
Menses were regular in a 28-day cycle. They lasted about 9-10 days. She did not experience any menstrual pain. The flow was heavy in the first 3 days. She had white discharge at the end of her period and occasionally in between cycles. There was a slight odor to the leucorrhoea and the texture was white and jelly-like.
She complained of hair fall.
Urine and stools were ok. No constipation.
Her tongue was clear.
Mentals
She did not like to be controlled; felt suffocated when someone told her to do something or even when her parents gave her instructions. Otherwise, she shared a good relationship with her parents and friends.
She liked a sense of disorder, especially with her things, and did not like it when her mother told her to tidy things up.
She was generally not very comfortable in enclosed places, such as lifts; felt very claustrophobic. She also felt nauseated in crowded places.
When she cried, she preferred being left alone. She also did not like it when someone tried to calm her down.
Whenever she felt angry at someone, she would talk it out calmly with the person and then let it go. She did not tend to harbour her emotions.
Other notes
Her last high fever (>38.5) was in August 2009 (about 7 months before this consultation). The fact that she had recently got a high fever means that her vital force was pretty robust.
Case Analysis
During the case-taking, it occurred to me that her physical symptoms were matching Sulphur very much. Even after repertorisation, Sulphur was coming up as the most prominent remedy. However, I did not feel absolutely convinced. Although her physical symptoms such as her desire for sweet drinks, her preference for cold weather, skin eruptions, and profuse perspiration were matching that of Sulphur, I felt that her mentals were leaning more towards Natrum Mur, with the exception of her preference for a sense of disorder that was more of a Sulphur trait.
Natrum Mur individuals do not like to be controlled. They basically hate to have any restrictions or constrictions imposed on them. This was present in Tara. This characteristic was also reflected in her mental sphere. She felt very uncomfortable in an enclosed space. Aggravation from the sun was another symptom that was strongly characteristic of Natrum Mur.
Overall, Tara had an introverted personality. She seemed like the sort of individual who was self-contained, with a good head on her shoulders. Her dislike for consolation was also another point I considered.
She did not have any of the other classic Natrum Mur symptoms such as a craving for salt. Despite this, I felt that the mentals presented a strong case for Natrum Mur. I gave her Natrum Mur 30C in water potency, to be taken once a day for 3 days, along with SL for two weeks. I decided to start with 30C as it was a low to medium strength potency and in this way, I would not exhaust the use of the higher potencies should it be required later on.
2nd Consultation – 8 April 2010 (about 3 weeks later)
Although I was expecting improvement at some level, I was pleasantly surprised to hear that the sleep-talking had reduced considerably. However, it was still there.
She felt that her face had begun to clear in the several weeks after taking the remedy. However, three days ago, her pimples starting coming back.
Her hairfall had increased significantly (+++) in the last couple of weeks and this was bothering her.
Her desire for sweet drinks had reduced and she drank water now.
Tara also felt that being in the sun did not give her those headaches as often. She now just felt a little warm in the occipital region when she went out in the sun.
Since three doses of the remedy had significantly helped her and the pimples that were beginning to clear were coming back, I repeated another three doses of Natrum Mur 30C in water. She was given SL as well.
3rd Consultation – 16 May 2010 (about 5 weeks later)
Her hairfall was much less.
She felt less uncomfortable in enclosed spaces.
Pimples were still there; pustular eruptions.
She now desired spicy food.
Sleep-talking reduced to once a week.
I repeated one dose of Natrum Mur 30C in water and gave her some SL.
4th Consultation – 9 June 2010 (about 3 weeks later)
Her period was delayed by about two weeks.
Sleep-talking increased to two times a week.
This time, I gave her one dose of Natrum Mur 200C as the 30C potency had been exhausted. Since Natrum Mur had helped with her sleep-talking, I thought a higher dose would work.
5th Consultation – 28 July 2010 (about 6 weeks later)
Tara did not have any episodes of sleep-talking.
She also reported that her period was now 6 days long. This was an improvement from the 9-10 days at the beginning of her treatment. Leucorrhea was also less.
Otherwise, her sleep and energy levels were good.
Although her appetite had reduced, she did not feel weak.
No remedy was given to her.
6th Consultation – 25 September 2010 (about 9 weeks later)
Her periods had been timely. The leucorrhoea had reduced.
Since recently, her sleep-talking had returned. It happened mainly in the mornings, when she slept in, which was mostly on the weekends. She had taken the last remedy almost 4 months back.
Otherwise, energy levels were ok and sleep was good. I also checked some of her earlier symptoms such as her perspiration and she said it was less than before and there was no smell. Her skin was better than before but the marks due to the acne were still prominent. Recently, she was starting to have pain in the head but it was not due to the sun.
She was now craving nuts, almonds, salty food and especially chicken. She also loved seafood. She also felt hungry in the late mornings towards 11am.
Hairfall was ++.
Analysis
Her symptoms were now indicating a different remedy. The desire for chicken and hunger at 11am were strongly indicative of Sulphur. Another symptom that confirmed Sulphur was her sleep-talking that came when she slept in. Sulphur has a distinct aggravation from prolonged sleep. I also felt that Sulphur would help with her acne scars, and bring about an overall improvement in her skin.
Even in the first consultation, the remedy Sulphur did come to my mind for her, but at that time I felt that the mental symptoms didn’t clearly indicate the remedy. There was the Natrum Mur layer, which had to be dealt with first in Tara’s case.
This time, I gave her Sulphur 30C, water potency, to be taken on 3 consecutive days, once early in the morning.
The patient did well with the remedy.
Some homeopaths may argue that I should have started her case with Sulphur since it was showing as one of the prominent remedies in the first consultation, and Sulphur being an anti-miasmatic, would have “opened up the case,” bringing out more symptoms. Maybe Tara would have seen results faster with Sulphur – I will never know!
