SL (23 years) needed treatment for severe, intractable vomiting. It had become a recurrent feature before and during her menses. During that time, she isn’t even able to retain water and so would avoid drinking it. Over the last 4 months she has lost 10 kgs as no allopathic or homeopathic treatment had helped her. Before the onset of vomiting she notices a ‘stiffness’ especially in the upper part of her body and an uneasiness in her stomach – as if cramped. She also gets an intermittent twitching on the right side of her head and in her right fingers and arm.
She has a history of ‘fits’ in 1991 and during that time as well she had intractable vomiting. Before the onset of these fits she has noticed a “shaking and shivering” of her right hand and thumb. This then recurred prior to every seizure. During the seizure she would feel her head churning at high speed (like vertigo). Her fingers were tightly closed into a fist so hard that one could see deep impressions of the nails in her palms. She was aware of the family talking around her and she was frightened. It would last about a minute. Then her right arm and hand would go numb. This was followed by nausea and an inability to retain any food. She had taken the requisite 5 years of antiepileptic medication and also subsequently developed the various physical side effects of the same – gum problems, sleeplessness, etc.
Significant past history:
As a baby of 7-8 months, she was diagnosed with ‘some fever’, for which a lumbar puncture was done (spinal fluid was analysed). Following this, she used to weep at night in her sleep – there were no tears though (like a moaning child). For months after that she could not eat much at all.
At 9yrs of age, she had recurrent epistaxis (nose-bleeds) in the summer.
She also used to get recurrent skin rashes in the summer.
Some Highlights from the M/E Picture:
She feels fearful and does not like to be alone especially during her seizures and vomiting. She hates anyone to find fault with her as she feels she rarely makes mistakes! She used to be frank in her opinion of people and things, but lately realized that she could not tolerate the repercussions of that, it made her physical symptoms worse and so she’d rather tell people what they want to hear. She is very particular about her diet (due to the vomiting), because she could eat almost nothing – everything produced spasms and pain in her abdomen after 2-3 spoons. So she wanted my opinion on every item of food that she took. Is yogurt Ok? Is juice Ok? Is milk Ok? Is salt OK? She had been eating only boiled vegetables, salt-less for the last 4 months!
The emotional issue that was significant with SL was that she was very sensitive to conflicts that happened in her family, especially if she was involved. She felt criticized by her father because he considered her a “sick” person. She used to get angry frequently and usually expressed herself – because she felt too weak to control these feelings. Two situations she explained were:
1: My father gets angry easily. Mom calls my father to come for dinner while he is watching TV. My father gets angry and says, “You finish dinner and go to bed – I will eat and go to bed when I like”. (My mom and Dad eat together always). If I interfere saying, “Dad, it is now 11pm. If you have dinner, then Mom can finish her work and go to bed”, then my father would tell me seriously, “You take care of your own things first. Eat properly and be healthy. Why do you involve yourself in this matter?” I feel hurt and think, ‘As I am not healthy, he is talking to me like that’. In that situation if I feel physically weak (unable to defend herself), I would be having choking (spasms) and cannot talk for a minute.
2: I had wanted to conduct a Fashion Show in the college. For that, I needed Rs 20,000/-. I talked to my brother about the show and asked his suggestion. My brother replied saying – “You earn that money and conduct the show.” My feelings were hurt, I was very angry and began to feel the spasms and choking again. I expected my brother to say a simple ‘No’ instead of saying “earn and conduct the show”. He knows I’m not in a position to earn such amount. 20 days later, my brother told me, “OK I will give the money – conduct the show.” (My brother is a businessman – sometimes in his mental state about business issues, he reacts like that). I replied saying I am not interested now to conduct the show.
Vomiting – menses before X during: am-c., am-m., ant-c., ant-t., Apoc., bry., calc., carb-v., carbn-s., carc., caul., cham., chin., cocc., coff., con., crot-h., cupr., foll., gels., graph., ign., kali-bi., kali-c., kali-i., kali-p., kali-s., kreos., lach., lyc., nat-m., nux-v., phos., pitu-a., puls., sars., sep., sulph., tarent., thlaspi, verat., vib.
STOMACH; VOMITING; General; drinking, after; agg. (K532, K1267, G453, G1045)
Convulsions upper limbs X followed by numbness in limbs: acon., agar., am-c., Apis, ars., Bell., bry., cann-i., caust., cham., chin-ar., cic., Cocc., croc., crot-c., cupr., hyos., ign., iod., kali-bi., Lyc., lyss., merc-c., nat-m., nit-ac., nux-v., phos., Plat., plb., ruta, sec., sil., staph., stram., sulph., sumb., verat., Zinc.
Clenching fingers in convulsion X convulsions fingers: am-c., ars., arum-t., bell., camph., cham., cic., cocc., Cupr., dros., hell., ign., ip., lach., lyc., nux-v., phos., sec., stann., staph., sulph.
GENERALITIES; CONVULSIONS; vertigo; with
MIND; MOANING, groaning; tendency; night (K67, SI-754, G53)
The analysis of the physical picture clearly pointed to Cuprum, with the possibility of Cocculus or Cicuta. I chose to present relevant portions of this history here, as it exemplifies many aspects of the Cuprum picture of the Materia Medica and we see the various components that should be part of a Curprum prescription.
On the physical plane, cramping and spasms are associated with all complaints, along with the tendency to convulsions with vertigo. On the mental plane, there is the characteristic anger aggravated by criticism and also a large component of fear.
While the physical symptoms clearly pointed to Cuprum, perceiving the mental state was a little more difficult. Scholten’s perspective was very helpful in perceiving the Cuprum Core and clearly helped in ruling out Cocculus and Cicuta. Below, I have highlighted some parts of the excerpt from Scholten’s Elements.
Mental/Emotional aspects of Cuprum:
From Scholten’s Elements:
Picture of Cuprum metallicum
Essence: maintaining control: cramp.
–Holding on to your work: serious
These are serious people who work hard. They want to get on with their work, to carry on and expand. They are not allowed to ease up, whatever has been built up should be maintained. They are serious, hard working, responsible, sometimes even extremely ambitious or fanatical.
–Maintaining control: cramp
They don’t want to lose control and this tendency to hold on can cause cramps, either on the emotional or on the physical level. They have to be kind and keep their emotions under control, but it is rather a forced sort of smile. They won’t let go of their own ideas and thoughts, which are often very conservative. They are rigid and precise. The physical signs of this rigidity are usually symptoms of cramp, often cramp in the calves, as if they are always having to stand on tip toes. But they can also be cramps anywhere else in the body; in the thighs, back, stomach, heart etc.
–Maintaining order: telling tales
Rules are there to be obeyed. As long as they follow the rules nothing can go wrong. Or if something does go wrong they won’t be blamed, because they have always obeyed the rules. They love rules, it gives them a sense of security. And it is very important to them that nobody steps out of line. If someone doesn’t follow the rules they will report them. These are the children who tell tales.
–Detaining people who make mistakes: guard
Their desire to control can be quite obsessive. Everything has to be checked, everything has to be perfect. They consider it their task to maintain order and can get very angry if other people step out of line.
–Maintaining order: ritual
Another way of maintaining order is through ritual. Ritual is a key word for Cuprum. Their rigid desire to follow the rules can lead to ritualistic behaviour, a seemingly meaningless set of actions that are constantly repeated in the same order. This remedy could be very useful for people who are frequently involved in rituals, people such as priests or judges. There is often also a sort of superstitious element in these rituals, ‘touch wood’, ‘cross your fingers’ etc.
– Protection against criticism
They are very sensitive to criticism, especially when someone tells them they haven’t stuck to the rules. They don’t want others to interfere with their affairs. They can get extremely angry when someone criticises them, or touches them, or even looks at them. Cuprum children don’t want to be touched, looked at, carried or driven. Hence their desire to hide or to escape. They want to avoid criticism and the pressure and restrictions of having to fulfil their task. Pressure of work can aggravate their complaints and if it gets too heavy they don’t want to carry on any longer.
Their own criticism of other people is always about not obeying the rules or not doing their duty.
We also see the theme of attack and defence in SL’s responses. She felt attacked by her family members and an inability to defend herself, but in her angry response to this, she produced spasms of muscles in various parts. She is fearful by nature, as fear was also a prominent part of her seizures and vomiting. She constantly needed her family around to look after her and protect her from harm.
She says she rarely makes mistakes and so feels very upset if she is criticized or anyone finds fault with her. This aspect could be explained by the rubrics:
o Delusion, pursued, police, by.
o Delusion, arrested about to be
The idea to put up a ‘Fashion Show” for a college programme at the cost of Rs. 20,000 (~ $500) speaks a little bit of grandiosity!
o Delusion, great person, he is a.
o Delusion, officer, he is an.
o Delusion, rank, he is a person of.
These aspects are further explained by Sankaran.
From Sankaran’s Soul of Remedies
The main feeling of Cuprum is that of being attacked. He feels he has to be prepared for a sudden attack and has to attack back. This feeling comes in paroxysms (in contrast to Zincum which feels attacked continuously). This is the theme of war, and Cuprum has a lot to do with war and armies. Cuprum has delusions of being an officer, a great person, a person of rank, a general.
This feeling of being attacked and the need to defend is also reflected in his hobbies, which often include the martial arts such as judo, karate, etc. Funnily enough, Cuprum has the symptom: “Fists are clenched during convulsion”.
In children, this feeling is seen in the form of a fear of being approached; the child cannot bear anyone coming near her and reacts immediately by striking, shrieking, biting, spitting, rage, kicking, attacking with fists, etc. One occasionally sees such children in the clinic.
o Fear, strangers, of.
o Imitation, mimicry.
o Rage, biting with.
o Rage, shrieking with.
o Rage, violent.
o Spit, faces of people, in.
In Cuprum, we have the theme of performance as well. Cuprum has: “Delusion, he is selling green vegetables”, “Delusion, he is repairing old chairs”. These are very ordinary occupations and Cuprum needs to be much more than that, he needs to be a general.
Some more Mind Rubrics: Cuprum could well be a remedy for people who join the Defense Forces. The Delusion rubrics are expressive of this frame of mind. Having such a frame of mind in ordinary occupations and responses would be an indication for Cuprum or one of its salts as a remedy, confirmed with well documented physical symptoms. (Cuprum Aceticum, Cuprum Ars, Cuprum Phos are most commonly used.) They do not like ordinary occupations and like to be people of rank. Here it has to be distinguished with other elements in the Silver and Gold Series.
Children show a different face of Cuprum as Sankaran has described, that can be confused with Belladonna, Hyoscyamus, Lachesis, Stramonium and Veratrum, especially as in these remedies, the tendency to spasms, convulsions and spasmodic respiratory and GI infections are common.
o Ailments from excitement, emotional.
o Anxiety, paroxysms, in.
o Bite, desire to.
o Fear, approaching him, of others, children cannot bear to have anyone come near them.
o Fear, strangers, of.
o Imitation, mimicry.
o Rage, biting with.
o Rage, shrieking with.
o Rage, violent.
o Spit, faces of people, in.
Physical Indications of Cuprum:
Below are symptoms that has indicated Cuprum in the physical pathology. One finds these indications easily if it is a case needing Cuprum, as they are quite characteristic. The remedies that need to be differentiated are:
Bell, Lachesis, Ipecac, Bromium in Respiratory/Cough or GI symptoms
Cicuta, Stramonium, Zincum in convulsions.
Lippe’s redline symptoms and keynotes:
Contact renews and aggravates the ailment (Nux-V.)
Giddiness accompanying almost all ailments, the head falling forward and on the chest.
Metastasis to the brain from the other organs
Constant protrusion and retraction of the tongue like snake (Lach.)
CONVULSIONS WITH BLUE FACE AND CLENCHED THUMBS
Spasm of the glottis (Brom., Chlor., Lach., Phos., Samb.)
there is blueness of the face and lips (Carb-V., Lach., Verat.) Delirium in attacks, with incessant, disconnected talking
VIOLENT CONVULSIONS, WITH PIERCING CRIES (Apis, Bell., Glon., Hyos., Plb., Stram., Verat-V.).
Spasms or convulsions beginning in fingers and toes and spreading from thence
Affections arising from repercussed eruptions, brain affections, convulsions, etc.
Convulsions during pregnancy (Apis, Cedr., Cham., Cic, Hyos., Lyc.) Puerperal convulsions (Bell., Cic., Hyos., Stram.)
SEVERE SPASMODIC PAIN IN THE ABDOMEN WITH CONVULSIONS (Plb.).
ICY-COLDNESS OF THE WHOLE BODY (Camph., Carb-V., Kali-P., Laur., Phos., Sec., Verat.).
Metallic taste in the mouth (Cocc., Merc., Nat-C., Rhus-T., Seneg.) CRAMPS OF THE MUSCLES, THOSE OF THE CALVES AND THIGHS ARE DRAWN UP INTO KNOTS
Cough relieved by a drink of cold water (Amm-Caust., Caust., Coc-C., Iod., Kali-C., Op., Sulph., Verat.)
Cold water also relieves vomiting (Phos., Puls.)
Whooping cough: the attacks come on in quick succession, accompanies perhaps by spasms, threatening suffocation (Ipec.) Mental or bodily exhaustion from over-exertion of mind, or loss of sleep (Nux-V.) [N.]
AGGRAVATION: At night; from contact; from repercussed eruptions; during pregnancy; about new moon; from loss of sleep; in cold air; from cold wind; from suppressed foot-sweat; and before menses.
AMELIORATION: From pressure; by a cold drink; and during perspiration. RELATIONSHIP-COMPARE: Ars., Bell., Camph., Canth,. Carb-V., Dig., Ipec., Kali-P., Lach., Laur., Naja., Op., Phos., Sec., Stram., Tereb. and Verat. COMPLEMENTARY: Calc. Verat. FOLLOWS IT WELL in whooping cough and cholera; and Apis and Zinc. in convulsions, from suppressed exanthema.
Clinical Insights from Pierce:
It is to be thought of in convulsions from worms, uraemic convulsions following cholera and puerperal convulsions, in all of which the spasms “are apt to begin with cramps in the extremities, especially in the fingers and toes” (Hughes). It is of especial value in convulsions preceding the outbreak of the eruption in scarlet fever or measles, or in the repression of the eruption, with symptoms of meningitis. The convulsions are ushered in with spasms of the flexor muscles, the thumbs clenched, and are accompanied by loud cries, frothing at the mouth, and blueness of the face and lips.
Cuprum is of great value, and is used by many as a routine remedy, in after – pains, and especially so for women who have borne many children.
It is to be thought of in laryngismus stridulous and in spasmodic asthma, with thumbs clenched in the palms, blueness of the face, constriction of the throat and dyspnoea so intense that even a handkerchief cannot be tolerated near the face.
In whooping cough it is of great value, especially when the spasmodic character of the cough is very prominent; there is vomiting, the face becomes purple and the child seems to almost suffocate. The paroxysms are better from drinking water.