1st visit 17. 2. 2021
A woman, 24, comes with eczema, depression, and gradually worsening food allergies. She reacts to tomatoes, strawberries, oranges, and fruit juices. By gradual worsening of her condition, she means that the range of foods to which she is allergic keeps growing.
Eating the foods she does not tolerate well causes eczema and itching. At present, she has eczema all over her body except for her face (on her face, it appears only rarely and in a mild form on the cheeks).
Eczema got much worse when she started studying at university. At the same time, her sleep got worse as well – it takes her very long to fall asleep (2).
The eczema is most aggravated after sour foods – especially after oranges and tomatoes (3). She can, however, see the aggravation also after most other foods except for bread, rice, milk, and vegetables (other than tomatoes). The eczema is also worsening after sour wine (2).
Since she had started studying high school, her psychological condition got worse. She was not as popular in high school as she used to be in primary school, which came as a shock to her. There are periods when she feels hopeless and others when she feels better. However, she generally lacks the zest for life (2). When she is depressed, she weeps at night (2).
She expects much of herself, wants to be perfect for others, thinks about school all the time, and says she wants to be perfect at everything (3). She strives for good grades but says that she feels she has lost herself. Very often, she feels she doesn’t have enough time and is rushed (2).
Her overall condition (both eczema and psyche) greatly improves by sea (3). She also feels much better after jogging (3).
She suffered from an eating disorder in high school. First, she lost a lot of weight, which caused her to lose her menses for 3 years, and then, she started binge eating.
Photos of the eczema before the start of a homeopathic treatment
My thinking during case analysis and choosing the remedy
Oleander was the first remedy I thought of. We must always think of this remedy if we have a patient with eczema that is greatly aggravated by acid foods, especially oranges and tomatoes. This combination of symptoms is a keynote of this remedy in both the materia medica and the repertory, see below. In both rubrics, Oleander is the most important remedy.
I also considered Antimonium crudum, a remedy combining skin and gastrointestinal complaints (here, food allergies). This remedy is also the one most aggravated by sour foods out of the entire materia medica – it is a keynote of this remedy, just like aggravation by sour wine.
Medorrhinum was the third remedy I considered in the first phase of the interview; we can find it in the rubric of “aggravation by oranges”, it also covers alternating moods (in this patient, this manifests as the alternation between despair and periods when she feels better). We also see a strong overall improvement by the sea in this patient, which is another keynote of Medorrhinum.
The turning point in my thinking came when the patient began to describe her mental state. Oleander is a small remedy of which only few mental symptoms are known. One of such symptoms, violent anger, which is quickly replaced by regret, is, besides Oleander, also a keynote of the remedy Crocus sativus. However, this patient’s psychological problems were very specific and none of the above-mentioned remedies (Oleander, Antimonium crudum, Medorhinum) matched them.
The psychological problems started in high school, where she was not as popular with her classmates as she had been in elementary school. She spontaneously said that it was a shock for her. This information was crucial for me because if we know the situation that led to the development of the current difficulties (etiology), we can try to find out how the patient felt in that situation and what effect it had on him.
In such situations, I always try to find out what specific emotions predominated in the patient at the time and, in this case, the patient tells me about these emotions spontaneously, without the need to ask for details.
The rubric of “ailments from mental shock ” is relatively large (see below) and none of the remedies of which this is a keynote (Acon, Op, Stram) match the mental or physical symptoms we find in this patient.
The strongest psychological feature of this patient was her desire to be perfect and to please others. At that point, I started to think about Carcinosinum, which is, albeit only in the first degree, present in the rubric ailments from mental shock. After a while, I realized that in this case, we can also see another important symptom of Carcinosinum, which can be observed in the two following symptoms:
1) There are periods when she feels better and periods when she feels hopeless.
2) In the high school, she suffered from an eating disorder. First, she lost a lot of weight, lost her menses for 3 years because of it, and then started binge eating.
The common denominator of these two symptoms is the alternation of opposing conditions, which is a keynote of Carcinosinum!
At this point, I started to look for other keynote or confirmatory symptoms of this remedy by asking specific questions and found the following:
She is extremely sensitive to criticism (3), fears she would mess everything up, says she can’t do anything, says she feels like she is useless, doubts herself, and doesn’t believe in herself at all (3).
Spontaneously (without questioning), she says she has always had more freckles than usual among her peers but recently, she has started to focus more on one of them and has developed fear of cancer (2), which she never had before.
Family history: grandmother – Type II diabetes, grandmother’s sister had cancer and died at 50; grandfather – Type 1 neurofibromatosis.
Problems with sleep (namely, with falling asleep, which is a keynote of Carcinosinum) was another confirmatory symptom that appeared at the same time as the aggravation of her general condition.
Amelioration at the seaside is another confirmatory symptom of Carcinosinum.
In Carcinosinum cases, I have often observed that we can find keynotes of several remedies but none of them can be confirmed; we also see contraindications to some of the remedies that seem indicated at the first glance.
In this case, we see the keynotes of several remedies:
Eczema aggravated by oranges and tomatoes – Oleander (but this does not correspond to the other symptoms)
Aggravation by sour food + skin and gastrointestinal problems – Antimonium crudum (but this remedy is not sensitive to criticism)
Amelioration by sea – Medorrhinum (which, however, does not cover the striving for perfection and the need to please others)
Improvement by jogging – Sepia (which, however, does not correspond to her mental state and is aggravated by sea)
Selection of the remedy, potency, and dosage:
Carcinosinum is the remedy we can best confirm by the combination of keynotes and mental picture. As the mental picture of the remedy was very clear and the remedy could be confirmed by physical generals (amelioration by sea, alternating conditions, family history, etc.) I decided to prescribe it, despite skin problems, at the potency of 200C.
Prescription: Carcinosinum 200C in a single split dose
1st follow-up 6. 10. 2021 – 8 months after the remedy
After taking the remedy, evening itching worsened. However, shortly after the remedy, her depressions completely disappeared and 4 weeks later, her eczema improved significantly. Her fear of cancer completely disappeared and her self-esteem slightly improved.
The eczema is much better, she has only small pimples, no itching at all during the day; at night, there is some itching only when she is stressed, and even then to a much lesser extent than before.
Before the remedy, she had eczema on her abdomen, neck, legs, and arms and sometimes (albeit slightly) even on her face. Now, her neck, face, legs, and abdomen are clear; only on her hands, a few pimples can be found.
Mentally, she is much better all the time, she has no depression states at all. She falls asleep without any problems. She has stopped having any allergic reactions to wine, lemons, and tomatoes.
She has a greater zest for life and for doing things. She was not happy about anything before; now she can feel joy. Her energy is about 50 % better than before Carcinosinum.
Analysis of the 1st follow-up:
The overall improvement after an initial aggravation is a very good reaction, especially if the improvement is stable. In this case, the improvement has lasted for several months without any signs of relapse, not only in terms of eczema but also in terms of her psychology, sleep, and reactions to foods, to which she had allergic reactions previously. For this reason, it is now necessary to wait without repeating the remedy.
Before the remedy After the remedy
Great case, Peter! Very good explanation of the way of thinking that led you to the correct remedy. Congratulations!
Excellent use of repertory and differential diagnosis and good grading of totality of symptoms. Good work Dr. Petr Zacharias.