Case Presentation:
A 42-year-old woman presented with relapse of multiple sclerosis (MS). Her first attack of MS was in 1998 which started as neuritis of the left eye. The second one was in 2008 with neuritis of the right eye. The third one was in 2017 with right foot numbness and formication after the death of her mother. This is the fourth attack of the disease. This time it started with blurred vision in the left eye followed by headache.
An interesting phenomenon in this case is that one month before every relapse, she developed either herpes labialis or genital herpes. She also has leucorrhea 3-4 times a year with severe itching. Panic attacks started 5 years ago and were followed by a depressive period. A psychiatrist prescribed Zoloft Tabl. Film. Coat. 50mg, 1 tab daily.
Physical symptoms:
- HEAD – PAIN – Temples
- HEAD – PAIN – Spot; in a small
- HEAD – HEAT – burning
- VISION – DIM – left
- MOUTH – TASTE – metallic
- MOUTH – TASTE – sweetish – metallic
- MOUTH – TASTE – sweetish – Tongue – Below
- FACE – ERUPTIONS – Nose – Inside
- FACE – ERUPTIONS – Nose – Inside – left
- GENERALS – MULTIPLE SCLEROSIS
- GENERALS – WEAKNESS
General symptoms:
- SLEEP – POSITION – side; on – right side; on
- GENERALS – FOOD and DRINKS – cold drink, cold water – desire
- GENERALS – FOOD and DRINKS – cold food – aversion
- GENERALS – FOOD and DRINKS – salt – desire
Mind symptoms:
– MIND – ANXIETY – health; about – relatives; of
- EXTROVERTED
- FEAR OF AUTHORITY
– FEAR – high places, of
- MIND – SADNESS
Past history:
She was operated on for uterine fibroids 4 years ago. That was followed by the appearance of benign fibroadenoma in the right breast.
Family history:
Mother – died from brain cancer
Sister – with rheumatoid arthritis
Level of Health:
According to the Levels of Health, the patient belongs to Group C, Level 7. People belonging to this group have mild acute conditions without or with very low temperature. When we raise the patients and they go to Group B, we expect them to have an acute condition.
Repertorization:
On Radar 10 the remedy I was thinking of appeared on the 21st position. Then I entered the same symptoms with the same degrees in Vithoulkas Compass and the remedy came out on the first position.
Analysis:
According to the symptoms, the case looks like Phosphorus. I decided to take some small rubrics as well as some strange, rare and peculiar symptoms:
HEAD – PAIN – Spot, in a small;
HEAD – HEAT – burning;
VISION – DIM – left;
FACE – ERUPTIONS – Nose – Inside – left.
Then I saw that Borax covered these rubrics very well. From Materia Medica we know that Borax is the main remedy for leucorrhoea and herpes.
Prescription: Borax 9C 3 x daily
Follow Up: 2 weeks after the remedy
The next day after taking the remedy, the patient experienced a worsening of the headache and vision. She had severe weakness for a few days. Within 7 days the headaches became better, after 5 days the vision started to improve indicating that the remedy is correct according to Herring’s law. The metallic and sweetish taste in her mouth disappeared. Herpes in the nose has also disappeared.
Prescription: Borax 9C 1 x daily
Follow Up: after 2 months since last follow up
For several days she had sore throat, fatigue, dry cough, headache, husky voice, coryza and fever, sometimes up to 37.8 C. She doesn’t remember having such temperature since childhood. Mentally and emotionally she feels better.
Analysis:
According to the Levels of Health of Prof. Vithoulkas the patient belonged to Level 8 and now the organism is trying to go to Level 7, where you have sub-febrile temperatures with mild acute illnesses.
As the patient has an improvement on the mental-emotional level and there are no symptoms to indicate another remedy, we leave her only on her main remedy Borax 9C during this acute condition.
Follow Up: 2 months after the last one
Again an acute condition with pain in temples, pain in throat and general fatigue. Along with this acute condition there is a return of old symptoms from previous MS relapses: weakness in the right leg and right arm, mainly in the fingers; also she cannot lift up her left arm.
Analysis:
In this follow-up, the patient has a relapse of symptoms. Often we see that an acute bacterial or viral condition can aggravate the chronic disease. We need to repeat the medicine in a higher potency.
Prescription: Borax 200C three doses every 12 hours
Follow Up: 2 weeks after the last one
Cystitis complaints have been reported for several days along with leucorrhea. She used to have such complaints before which means we have a return of old symptoms.
Repertorization of the acute symptoms:
Prescription: Cantharis 200C three doses every 12 hours
Analysis:
We see that the patient goes up in the levels of health to Group B where we have frequent acute conditions. This means we should expect her to develop another acute condition.
References:
Vithoulkas G., The Science of Homeopathy, International Academy of Classical Homeopathy, Alonissos, fifth edition 2009.
Vithoulkas G., A New Model for Health and Disease, International Academy of Classical Homeopathy, Alonissos, expanded edition 2008.
Hahnemann S., Chronic diseases, Jain Publishers, New Delhi, reprint 1992.
Hahnemann S., Organon of Medicine, Sixth Edition.
Hahnemann S., Materia Medica Pura, Jain Publishers, New Delhi, reprint 1984.
Kent J. T., Lectures on Philosophy, Jain Publishers, New Delhi, reprint 1989.
Kent J. T., Lectures on Homeopathic Materia Medica, Jain Publishers, New Delhi, reprint 1984.
Hahnemann S., Organon of Medicine, sixth edition, paragraph 201-208.
Kent J. T., New Remedies – Clinical Cases – Lesser Writings, Jain Publishers, New Delhi, reprint 2005, Correspondence of Organs, page 273.
Dear Daniel,
A nice prescription and (preliminary) outcome on Borax.
I would ask, in future, that more specific information be provided so that the reader may for themselves correlate and confirm with the source MM.
I would also mention Borax is not known to have produced itching leucorrhœa (rather for acrid), and is especially known to produce papules/pimples (Blüthen – refer CD122-124,410), not vesicles (Blattern/Blasen) though it does produce those also (to a lesser degree [e.g. on the tongue, CD153]). The eruptions produced by Borax are painful, erosive, aphthous (Schwämmchen; see CD150) – i.e. not, as you say, “From Materia Medica we know that Borax is the main remedy for leucorrhoea and herpes.”
It is important not to generalise (as done in allopathy), with monolexic descriptions “leucorrhoea” “herpes”, etc. – we need symptoms to be as complete as possible – this means a description of their specific location, and modalities wherever possible (this was taught well by Hahnemann, and incorporated into the TT model repertory by Bönninghausen. For example, the Borax leucorrhœa was reported by Schréter (Hahnemann’s Chronischen Krankheiten) as follows:
304 Leucorrhœa, white like mucus, without other troubles, fourteen days after the menses (aft. 5w). [Srt]
305 Leucorrhœa, like the white of eggs, with a sensation, as if warm water was running out, for several days (aft. 12d). [Srt]
306 Leucorrhœa, thick like paste [dick wie Kleister] and white in colour, for five days (aft. 4d). [Srt]
307 A woman who had been sterile for fourteen years, and who, on account of a chronic, excoriating leucorrhœa [wund fressenden Weißflusses], had, after several remedies, finally received borax, conceived, and the leucorrhœa improved. [Srt]
I would also note my great disappointment to read your confusion of “symptom” with “rubric”. It is a common but serious error to misunderstand that rubrics are summary representations and are not to be confused with symptoms. And your description of the case itself did not contain symptoms supporting your choice of many of the rubrics actually used.
Your use of the rubric (not symptom) “multiple sclerosis” places too much faith in something recruited without a basis in provings – the mere clinical removal of a symptom alone does not confirm that remedy could have produced that symptom, as for example, the removal of headache by aspirin is no evidence that is produces headache. So all such “clinical” entries must be closely examined before acceptance – to ensure indeed there is evidence to support the effect was indeed omoio-pathic.
Your recruitment of professor Vithoulkas’ “Levels of Health” (a model generally consistent with Hahnemann’s teaching) in your analysis does not serve to confirm the delineations of those levels – and it is too early in this case to draw any such longitudinal conclusions in a case of such infrequent relapses.
Dear George,
Yes, you are right, this case needs long-term follow-up. And it has.
Unfortunately, I can’t think up symptoms that the patient doesn’t have and I put them in the Reperty as they are in the patient. I haven’t adapted them according to MM. In Boekicke’s, Boenninghausen’s and Boreg’s MM is very well written that Borax is a well-shown remedy for herpes and white flow from vagina, etc.
When it comes to a serious illness such as MS, it is unlikely to be cured with aspirin or placebo, as you wrote. Only this would happen with the right homeopathic medicine.
If you know the Health Levels well, you will find that when a person has not had a fever for a long time, and then starts again and along with it there are frequent acute conditions, the patient has risen to group B.
The rest of what you have written is pure speculation and your interpretations of my case, which refer to your imagination. Which unfortunately often happens and happens in Homeopathy, even by many world famous Homeopaths.
Dear Daniel,
It is difficult to comprehend how you could have so misunderstood my communication – I am familiar with the neuropathology of conditions like MS thus could not, and did not suggest aspirin or placebo as a cure. My mention of aspirin was with respect to determining omoio-pathicity (i.e. similarity of effect between drug and disease).
You also misunderstand my specific comment that you have confused “symptom” with “rubric.” Something which is unfortunately so commonly seen within our profession. And you have not answered this in your reply.
Instead of acknowledging the time taken for me to provide specific details from MM thus adding to the conversation for the whole readership, as was my aim, you reply in a combative tone, that the rest of my commentary was “pure speculation” and “imagination”.
This baseless accusation I reject entirely, and express my real disappointment that you have so wrongly concluded about my factual communication – please identify precisely where I have ventured into such imagination.
I have indeed read “Levels of Health” which was presented to me some years ago by Prof. Vithoulkas (for whom I have the greatest respect), and am aware of the model and its multiple delineations.
But let me be clear – your case example does not (and can not) show that the patient has ascended through the named levels as you have concluded – only that such ‘stirrings’ to acute reactions (which yielded to a good homoeopathic prescription) are to be taken as a move in the right direction – and this sort of reaction, as also the moving of disease from within outwards (e.g. onto the skin) as a sign of improvement, has been reported in the medical literature long before Hahnemann (who cites many such examples from various old-school authors).
Lastly, it was my intention to add to the discussion and provide substance for further consideration, for the entire readership. But your surprisingly discourteous reaction (in your last paragraph) indicates there is nothing to be achieved from further exchanges between us.
Dear George,
When you pass the full teaching of Prof. Vithoulkas by watching the E-learning program and graduating after successfully passing the exam at the Academy, then you will be in a position to criticize, refute, gainsay, oppugn, attack and dispute with comments on the case.
Instead of spending all your time on negative reviews, it would be more helpful for readers to write a better case than mine according to your understanding of “good case”!
Dear Daniel,
Thats really great succes and giving much hope about MS cases. clients health levels improvement is actually more then expectations, so I think we could expect and study more.. thank you for sharing..
Dear Sema, Thank you very much.
Doctor Rustev
Thank you for sharing your wonderful case. I learned a lot.
Kriste Sanders, D.C.
Thank you very much Dear Kriste!
borax is feared of noise and apples.some clinical minded say it is blood impurity fungus ascaride toxins.india we call it phatkari a minute q type added to water solidifies suspended impurities thus easily screened away.pure quality blood with proper o2 carrying capacity will improve brain anaemia enable to descend down stairs without hand catch by mother.mouth ulcers etc steriod therapy can be avoided.
sorry for my earlier comments may not be approved.india phatkari is alum not borax.these lines phatkari purify water etc be deleted.inconvenience caused is regretted.
Dear Er. SS Hari,
We know that in Homeopathy we have to prescribe the homeopathic remedy according to the patient’s symptoms. We also know that a homeopathic remedy has a symptoms that are unknown. This is especially true for the so-called small remedies.
When a hom. remedy cures certain symptom that is unknown in MM and at the same time we have a general improvement of the patient and find that other colleagues have confirmed the same symptom with the same remedy, we can assume that this remedy has in its picture this symptom. This is how MM develops.
Very beautifully penned Daniel.
Loved reading through your notes. I understand that only you would have had the actuals on clinical symptoms of the patient. Not mentioning them cannot be assumed that those were not attempted to find out at your end. Nevertheless, you cannot add symptoms based on imagination only.
Keep up the spirit.
I do see words like “disappointment” which seems to have affected not ignoring the learning that comes along. But somewhere it acts as a hindrance in absorbing the good. We all are learning and a constructive approach is much needed. As you rightly called out that is how MM develops…
Thanks for sharing 👍
Well done with the first prescription and analyzing, These cases are difficult and complex Still need follow up and update for a chronic syphilitic case at least 2 years to see the development. Do you not think that the causative factor is worth looking at , looking at this link mind-body and what triggers MS?For the leucorrhea , I don`t find it important , it is manifestation of sycosis which in not bad in this case, I would focus on the syphilitic features of the case and the nervous system ,to move it from syphilis to sycosis or down the levels . I treated leukorrhea successfully without necessarily being in the rubric ,but as the immune system starts recovery it naturally disappears and usually last .It will interesting to see how it is progressing.Good luck!