A Case of Ulmus Campestris – Physical Immobility & Depression

This case demonstrates how a smaller remedy was found by using the resources provided by modern homeopaths in an integrated way, and how the Materia Medica and themes of the simillimum shine light on the dynamic movement of the individual.

The client is a female professional in her 30s, mother of 2 preschool children. A capable, efficient, hard working individual who held a position of significant responsibility in her professional career. Family-oriented, feels overly responsible for her family.

Diagnoses, Chief Complaints, Non-Homeopathic Treatments

Genital Itching, Shingles/Herpes like symptoms appearing and disappearing during menstrual cycle. Periodically occurring over many years, but noticeable increase on October 17, 2020, during ovulation: Cramps, pelvic pain.  Herpes-like symptoms and vulvar itching. > Hot water bottles. Continued aggravation for the two weeks leading up to her period, amelioration after Menses. “Feel like the weight that I’ve been carrying has lifted.”

• Whole right side & waist is frozen and painful to touch.
• Extreme groin pain, patient is bedridden.
• Vulvar itchiness. Genital blisters appear

 Medical Treatment: Gynecologist prescribes a 7 day dose of Valtrex, but the cycle of symptoms continues.

 IMMOBILITY & Back Pain

A chronic background issue was severely aggravated on November 5, 2020: “Twisted my body getting my son into his car seat. Walking causes back to seize. Can barely move. Walk in baby steps and lie down on the ground in the fetal position, I’m in so much pain.”

Chiropractic Treatment Nov 5^th, 2020 Feel I will almost vomit from the ache of my back. From this point, it feels like it doesn’t shift too far out of this state anymore.

Physiotherapy Treatments weekly – November 10 2020 – January 2021 The pain gets a bit better, but then just comes back worse.

Summary of Symptoms at first intake January 6th, 2021:

1. Chronic Fatigue and Fibromyalgia symptoms. Exhaustion.
2. Immobility: Bedridden for 2-3 days at a time. Immense pain and heaviness in legs.
3. Cracks in feet have started to appear.
4. Shingles, genital Itching < menstrual cycle.
5. Profound sadness. “Feel sorry for myself, self pity, my sad, slow, pitiful, state.”
6. Feeling burnt out

Etiology

Everything worses since the beginning of COVID lockdowns and children at home rather than at school.  “Yeast infections, recurring groin and muscle pain (leaves me bedridden). Crippling depression- it’s quite debilitating for me and for my family. I don’t really know how to keep up.  I feel anxious, nervous, like something bad is going to happen. It’s the feeling of… doom, something’s about to happen. I have to keep walking myself away from fearful thoughts (relating to kids, husband, my own health, epidemics…). It’s pretty constant.”

• Worried about parents, kids. Keeps family (parents) close together: “Interconnectedness and mutual support is essential.”
• Home-schooling, kids fighting non-stop adds stress. Bending over and picking things up a lot (which has become too difficult)

Modalities

• Leg Pain < with any type of stretching.
• Depression, anxiety, Panic < worrying about people and loved ones – enormous stress
• Genital itching < start of ovulation, 2 weeks after ovulation until menses
• Back pain < 10 days following period – as if back would snap

Patient’s Words

“I feel delicate. Too Frail – thick and heavy, dense, as if a bone could break, could snap, but not like a bird that could collapse. As if morbidly obese from the waist down – as a lot of weight. As if I can’t move. It hurts too much to strengthen up, I am in too much pain. Hard to get up one flight of stairs, winded by every step. How do I get back the sense of strength? It is as if there are dense layers of fat, heavy, a mass of heaviness. Thick floppy. Can’t lift my leg. Want to be able to step without being stuck in the ground.”

In continuing to inquire into her sensations: “Thick, heavy, dense, covered with thickness, parts feel dead, thick, swollen, lifeless. Get grounded. Pushing me down++++, gravity pulling down +++, physical depression. Really boring, bland, bad mood, Slow, dull, not rising, not quick, restrained +++. Like walking through the mud, sticking in the mud, sucking mud, wedged in thick mud. Trying to pull out, to lift it. Planted, dense, pulled down into the earth.  Sinking down, immobility. Compression pushing me down, want to be up, not down – can’t move, all deflated. Stuck in the ground.”

When asked to describe the Opposite Sensations:  “Alive – vulnerable, if I touch it, it will recoil, sensitive, tiny vulnerable kid. Desire to jump, have a bounciness that I want – bounce, hop, land, spring up again, go, run, spring. Joy, the entire upper body is expansive. Hand gesture (HG) of opening up: can breathe. Everything is working together. As if 6-7 years old: curiosity, try things, do things. Freedom, sense of joy, overwhelmed with joy, at one with nature together. No purpose, no goal. Fun enjoyment, nature…float away.”

Case Analysis

The sensation level was the one most clearly pronounced and corresponds to the Hamamalidae as described in Dr. Rajan Sankaran’s Schema:

VITAL SENSATION: closed / enclosed, dragged down, pressed/compressed, feeling of being closed,  pressurized, confined, shut in, heavy.

The opposite: open, free, flying, and light, expanding, enlarged, floating.

The Hamamelidae subclass constitutes Row 2 of the new superclasses recently introduced by Rajan Sankaran (Column 2 in Michal Yakir’s system^[1]). Of the five orders in the Hamamelidae subclass, the Urticales Order seemed to be the best match, described by Yakir as: “striving to be strong without adequate self-knowledge. No effort or great efforts. Heavy burden. Interdependent.”

Patient’s words:

• “I am lacking the ability to feel strong. I want desperately to feel strong in my body. Want to be in a fighting stance: like an amazon warrior. Like wonder woman. Right now feel like a heavy, immobile old lady. My body is moving so slow and it feels so dense.”
• RUMINATING +++. Feel protective over my mother. My feelings are VERY strong – Can’t shake the thoughts…Feel like family is being torn apart and it’s stressful.

The chart below compares the four main families within the Urticales order of the Hamamalidae. (Notes synthesized from Franz Vermeulen, Sankaran and Michal Yakir.)

The Ulmaceae family and duties, worry and responsibility

The Ulmaceae seem to best correspond to the energetic dynamic of the patient. With the map provided in Jan Scholten’s Wonderful Plants, the Ulmaceae are assigned the number 3-644.64.00, with very strong row 4 mineral themes – work, task, society group and family.  In his description they take on responsible roles for their business and family, but inside do not feel strong enough to do them.

• Overwhelmed by duties, responsibilities.
• Desire: care of and serve others.
• Over-perfectionist.
• Energy: fatigue.

 Patient’s words

• “Profound sadness – I am not a good parent, it will kill me.“
• “Trauma of worrying about people and loved ones.”
• “Feeling burnt out. Kids are fighting non-stop which adds stress. Bending over and picking things up a lot. Getting worn out.
• “Level of responsibility and the stress – overwhelming.”

The BACH Elm and exhaustion

The Ulmaceae are the elm trees. For those familiar with BACH Flowers essences, it is easy to see how the essence ELM covers the core suffering of the patient of exhaustion quite well.  It is within the group corresponding to despondency or despair; exhaustion from over-striving for perfection with feelings of inadequacy. Those who feel overwhelmed by the responsibilities and scope of their work. The ELM type persons are very capable, efficient, and intuitive.

Patient’s words

• “Very fatigued throughout my body. Body is stiff – I can’t move like I am used to moving. Holding back to protect myself, but it’s just keeping me weak. I’m never pushing myself – because if I do, it will hurt my body, or I will pull something.”

Ulmus Campestris

The Materia Medica of Ulmus Campestris in Yakir’s Wondrous Order aptly covers all the important aspects of the case.  “They feel that life presents enormous challenges requiring great efforts to overcome them…  Ambitious, tend to be over-responsible and worry excessively. Plans: making many; cares full of- domestic affairs.

Gets stressed by small issues, trifles seem important…feeling that most challenges are massive and insurmountable. Very responsible: They feel the need to worry about their parents, children, grandparents, the house – everything and everybody… they feel that they don’t have a life.”

They feel as if they have run out of air (patient’s words: deflated vs breathing). Mahesh Gandhi is quoted as saying they feel “Life is dull and tasteless; there’s nothing for me to live for”. Self-pity.

Physicals(listed): weak ankles, formication and fungal infections of the feet (cracks). Creeping pain in legs and feet, rheumatic pains and multiple aches.

“They feel enclosed, trapped and heavy. I dreamed that I was wading in mud and all I wanted was to get out of it and fly. “

Ulmus Campestris confirmation Rubrics (just the confirming rubrics)

mind; PITY, pities; oneself (45) *

mind; CARES, worries, full of (190) * & waking, on (4) * & domestic affairs, about (9) *

female; OVULATION; agg. (60) *

female; PAIN; uterus; ovulation, during (2) *

generalities; OVULATION, ailments during (70) *

extremities; WEIGHT, heavy; lower limbs (8) * &  feet (3) *

extremities; HEAVINESS, weariness; weight, as from a (24) * & lower limbs (15) *

extremities; PAIN; sore, bruised; legs; walking; while (27) *

extremities; PAIN; legs; walking; while (147) *

back; STIFFNESS; motion; agg.; beginning, on (14) *

back; STIFFNESS; sacral region (46) *

back; STIFFNESS; sacral region; lying agg. (1) *

generalities; STIFFNESS, rigidity; motion; agg.; beginning (34) *

Homeopathic Prescription

Ulm-campestrus in the 1MK potency was prescribed on January 6, 2021. Even though the client provided a lot of sensation level words, the delusion level was more predominant in the interviews: the “as if” of being exhausted, overwhelmed by her responsibilities and her family being pulled apart. Although her symptoms were aggravated during the COVID shutdown, they had been present before to a lesser degree, and thus chronic. The chronicity of symptoms deeply ingrained in the PNEI, with hormonal involvement, and the fact that COVID shutdowns (the trigger) continued to be a maintaining cause, prompted me to prescribe weekly for 2 months.

FOLLOWUP Evaluation

As it is now a well-established scientific fact that Self Rated Health (SRH) SRH—is the single best predictor of health (Idler and Benyamini 1997), at MICH we have developed a short list of questions so that the individual can evaluate the direction the healing process is taking. The 6 key markers of health are: F= Freedom of Response, O= Optimism and Objectivity, R=Relationships, C=Chief Complaint (intensity), E=Energy and awareness of environment, and S= Sensations experienced by the patient.  The phrases in bold are what was determined at the initial consult, and thus form the baseline. The phrases in italics are what the patient experienced after 1 month and 2 months of treatment: reported on February 7^th and March 26^th 2021.

Freedom of response: Feeling like a prisoner in the body, weighed down, everything is so hard, life is so hard, demanding so much effort. Unable to move – as if I can’t move.

At F-UP: Feeling much better in my body. It’s like my physical ailments are reduced to 5% of my thoughts – whereas before they were front and center. Not feeling weighed down, not feeling like I can’t move. My body just isn’t heavy anymore. The aches and pains are only slightly there, and they just stay as a small blip – My body feels mine.

Optimism: No desire, apathy. “I can’t believe that I am so depressed – I no longer am optimistic, I struggle, I snap I feel so sad…Profound sadness.  Sad slow pitiful state.”

At F-UP: I don’t feel depressed. I’ve had weird moments of just feeling still a sense of “OMG – this is still going on (Covid that is)! Argh!” – I feel optimistic (had thoughts of going on future vacation). Not profound sadness anymore. I have moments of boredom, being tired – but that just feels like “it’s what’s going on in the world”… it’s not my core self.  Way better than the profound sadness of before!!

Relationships: Snapping at the children, Irritability. Worry & panic

At F-UP: Irritability is greatly reduced. The remedy totally loosened the tight feelings. I can only explain it as the thought (of worry) could finally complete itself. It wasn’t getting stuck in the panic moment anymore. It was like drawing a circle, that previously was getting jammed. Thought I would share, because after almost 3 years, that is the first time that pattern shifted. 

Chief Complaints: Pain in back, legs. Constant pain,  left upper back leg, Itching agg ovulation, depression. Cracks in feet. 

At F-UP: Body/leg heaviness and pain since first taking my remedy improved. Like 100%. I am no longer bedridden, I move, I do things, etc. No herpes this month. No vaginal itching (maybe a little but didn’t persist). After ovulation it was much better – and I was waiting for it to get bad. Physicals didn’t flare up. I would say before I felt I was very down these weeks after ovulation and this time, I didn’t feel rocked.   Seriously, the physical pain sensations are so so much better. I’m not struggling.

 Energy: Slow, dull, not rising slow motion, not quick, held back. Cannot go up stairs, cannot bend down. everything is a struggle, effort.

At F-UP: Went back to running, no problem with stairs, able to do housework, pick up after children, keep up with the workload.

 Sensation: Heaviness etc. see notes above

At F-UP: Also, so much better. Feel more alert – don’t feel like I’ll break. Just feel like I’m doing what I want to do , when I want to do it. I get tired, sure. Can’t run as fast as I would like to,  but, it’s not an overwhelming physical feeling.

March 26, 2021: Was instructed to take prescription as needed. Did not take any doses from July 2021 onwards.  September 2021: Continued improvement and good health: “I was quite my normal self. Felt pretty great physically and emotionally.”

February 10, 2022 Her son had to be taken to emergency. Had also moved into a new house, Covid lockdown was reinforced once again. “No boundaries, but being told that if I set them, it will be better. I know this is true but I feel small and incapable.” This kind of boundary issue is typical of the 2^nd row Hamamalidae (Sankaran and Gandhi Superclass).  Since the superclass map corresponds to the sensation level, Ulmus Campestris 10MK single dose was prescribed.

March 2022: Patient’s comments: “Grounding…I feel like anxious thoughts are outside the door. I know they want to come in – but I somehow am keeping the door closed. I can really feel myself keeping things out –  not aggressively, but in a self-assured way. My body feels more erect in this visualisation.”

 

^[1] Yakir, Michal: Wondrous Order – Systematic The Table of Homeopathic Plant Remedies, Narayana Verlag January 1, 2017ISBN-10 ‏ : ‎ 3955821099, ISBN-13 ‏ : ‎ 978-3955821098