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.

Analysis:

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.