Clinical Cases

Acute Case of Fever Blisters/ Herpes Simplex Virus 1, HSV-1

Marilyn Freedman
Written by Marilyn Freedman

Marily Freedman presents a case of fevel blisters in a woman of 21.

Patient: 21 year old Female

The patient is a young woman, medium build with long, dark hair, well groomed and very fashionably dressed.  I reviewed the intake form and saw that the only complaint she listed was frequent colds and cold sores. There was no family           history. She had just penned in “OK” on the third page of the intake form.

Practitioner:  Tell me about what is troubling you.

Patient:  I have these cold sores and they won’t go away. They keep coming back and getting worse. Go to Walmart and get one. Go to a bar and get one.

Practitioner: Since when have you had cold sores?

Patient:  This time 2 weeks.

Practitioner:  You have had them before?

Patient:  Yes, 3 years ago

Practitioner:  Have you been diagnosed by a doctor?

Patient: Yes.  I was on Valtrex and didn’t have any cold sores until now.

Now took Valtrex and getting a weird burning feeling, a tingle here and there.  Never had the burning or tingling before the Valtrex. Popped antibiotics every time I felt a sore throat or cold.

Practitioner:  What has been going on with you over the last few months?

Tell me, for instance, if there has been any stress lately?

Patient:  Worked somewhere and they closed down a few months ago.

She starts crying.

Practitioner:  How come you are crying?

Patient:  Getting cold sores – really self conscious about it.

Practitioner:  Tell me what happened a few months ago when your work closed down?

Patient:  Where I was working closed down 2 months ago. Period was late too.  Was working at a dog day care as co-op. Started working at another dog day care. Only lasted 2 weeks, boss was brutal.

Practitioner: Tell me, how is your relationship with your mother?

Patient: Relationship with mother good, now. Family just came to Canada.

Mom is not crazy, but she has her moments.

Practitioner: With mom or dad, which did you have the most difficult time?

Patient: Mom

Practitioner: Cravings?

Patient: Salty

Practitioner:  Do you like company or prefer to be by yourself?

Patient: Prefer to by myself.

Practitioner: How do you take it when you are upset and someone tries to make you feel better, to console you?

Patient: Don’t like when people try to console me.

Practitioner:  Are you thirsty or thirstless?

Patient:  Thirsty

OBJECTIVE FINDINGS

Review of systems:

I performed a physical exam: I asked the patient if I could look at, and touch the cold sore. She said yes.  I put on a pair of disposable gloves.  She pointed out the spot where she felt it. I took a flashlight and shone it on her skin around her mouth.   I observed three small red spots approximately 1/2 mm in diameter on the left hand  side of her upper lip.  I touched the spot and felt that it was raised.  It was just the beginning stage.

HOMEOPATHIC DIAGNOSIS

This is an acute miasm, according to the Organon of the Medical Art,  6th ed., aphorism 73: an individual acute febrile disease which is a passing flare up of latent psora which then becomes dormant again.

Based on queer, peculiar, striking, uncommon characteristics and on the presented symptoms I approached the analysis through the totality of symptoms.

Mentals:  doesn’t like consolation

Physical Generals: craves salty, thirsty

Particulars: cold sores

The patient’s symptoms were repertorized as such:

Craves salty: general

Stomach, Desires: Salt things

Doesn’t like consolation: generals

Weeping, tearful mood, etc.: Consolation agg:

Cold sores: particular

Mouth, Lips: Cold sores, herpes, hydra:

Thirsty: general

Stomach, Thirst:

The remedy which came up covering all the symptoms was Nat-mur and all           symptoms covered were grade 3. The other remedy considered was Sepia which only covered three of the four symptoms. Nat-mur is complementary to Sepia.  Sepia follows well after Nat-mur.

Boericke’s Pocket Manual of Homeopathic Materia Medica – The peculiar symptom of the patient that she is always catching a cold is found in the 1st paragraph, “great liability to take cold”, taken into consideration but not repertorized.

The patient seems to be a sensitive person who is withheld and evasive – closed. Also, the Nat-mur patient develops cold sores around the mouth as the first pathology, likely occurring after grief or humiliation.

The differential diagnosis is with Sepia.  Sepia, according to Essence of Materia Medica, by George Vithoulkas, is about statis, stillness of emotions, feeling without emotions. This was not the case with this patient.  She cried about her state.

Prescription:

Based on the patient’s susceptibility I gave Nat-Mur 30 ch potency 5 pellets 3 times a day for 4 days. I advised the patient to take vitamin C, 1,000 mg per day and vitamin B complex as per label to help boost her immune system.

The patient came by herself this time to the consultation.  She greeted me with a big smile. She was happier this time.

Practitioner:  How are you feeling since you took the remedy?

Patient: Cold sores helped tremendously. I haven’t gotten full eruption.

Sometimes get a sensation, or get redness.

Practitioner: Are you happy with what’s going on?

Patient: Very, I know it’s working

Practitioner:  How is your relationship with mom?

Patient: She’s kind of depressed. It’s better if we don’t speak. She brings her problems on me and my dad.

Practitioner: Has there been a change?

Patient: Yeah, I’m over it, don’t care so much, brushing it off. Getting out of the house and doing things. Before I was so insecure, so worried about going out. I used to go out and get a cold sore.

My thought process was that the remedy was working since there was a positive change in the physical state as well as the mental outlook.  Since the remedy was still acting I decided not to give the patient the remedy again at that time.

At this point in time I told the patient that since the remedy was working we should wait to let it finish its action. I explained to her that we would wait another month to see what was going on.  I told her that if she felt that the cold sores were getting worse to call me right away and I would give her another dose. The patient told me that she was very happy not to have to take more medicine and that she was following my dietary, lifestyle, and vitamin recommendations and feeling better.

I called the patient a couple of months later to see how she was doing and she told me that she was feeling much better, not experiencing any more episodes of herpes,  and was going for job interviews.

References:

Pathophysiology, The Biologic Basis For Disease In Adults & Children,  Kathryn McCance,  4th ed. Mosby, page 1453

Compendium of Pharmaceuticals and Specialities, Canadian Pharmacists Association

Organon of the Medical Art Samuel Hahnemann, 6th ed.,edited by Wenda Brewster O’Reilly

Boericke’’s Pocket Manual of Homeopathic Materia Medica and Repertory, 1998 ed.

Heal Thyself, The Homeopathic World, a popular journal of Medical, Dietetic, Social and Sanitary Science by J Ellis Barker, 1936 May, Vol LXXI No 845.  The author is Petrie Hoyle. The subject is Materia Medica.

Essence of Materia Medica, by George Vithoulkas, B. Jain Publishers, 2002 ed.,

Concordant Materia Medica, millennium ed., Emryss pub., by Franz Vermeulen,

About the author

Marilyn Freedman

Marilyn Freedman

Marilyn Freedman B.A. HOM, has been in private homeopathic practice in Canada since 2004. She works with the regulatory College of Homeopaths of Ontario on the implementation of entry-to-practice competency education and evaluations. She currently facilitates salon style continuing homeopathic education (canadianhomeopath.ca).

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