Master Case Taking with the Masters Course

Autism in a Girl of 6

Written by Victor Cirone

CCHM alumnus Victor Cirone shares a case of autism in a girl of 6. The symptoms of emaciation accompanied by distension of abdomen and intelligence, narrow field helped lead to the simillimum.

This is the case of a 6-year-old girl who is on the autism spectrum and is facing a variety of cognitive and developmental challenges. She is non-verbal and, as such, the case was presented by the child’s mother. The initial consultation was conducted in May of 2021.

Case Report:

The symptoms which characterize the case are as follows:

Behavioural changes after vaccination, including loss of the ability for verbal communication. The patient was not always non-verbal; only after her routine childhood immunizations did she lose the ability to speak. One particular vaccination could not be identified as the primary causative factor, as the changes to verbal communication were gradual rather than sudden.

After vaccination, the child’s attention also changed. Before she was able to focus e.g. she was able to look at a camera when her photo was being taken. After about 5 months post vaccination, it was as if she was unable to consciously direct her attention towards anything in particular

There was also some concern that the child’s hearing had been affected, as for a time she would no longer respond to loud noises. Diagnostic testing however showed no physiological issue with the patient’s hearing.

While the patient is non-verbal, she does have a desire to communicate. Communication is difficult with other children, who tend to ignore her because of her inability to speak. In general, she can connect more easily with adults for this reason.

She does demonstrate a clear desire to interact, as can be seen when she tries to imitate what other children are doing. She has been around other non-verbal children, and has been able to connect well with them. The patient is very affectionate and she is fond of touch.

Epileptic seizures occurring at night during sleep; general difficulties with sleep. The patient has only experienced three major epileptic episodes that required medical attention, but there is a strong suspicion that milder seizures are occurring on a much more regular basis.

This is indicated by the patient waking up and being generally ‘out of sorts’, noticeably lethargic for the most of the day. EEG testing revealed that the child’s brain lights up and becomes very active at night and during sleep – no indication was given as to why this might be so.

The patient was prescribed Clobazam, a benzodiazepine used in the treatment of epilepsy, but the patient’s mother was hesitant to continue treatment with this drug as she observed that it prevented her daughter from falling asleep.

There is some association to the seizures happening when it is very hot at night.

There is however no perspiration during seizures. During a seizure the patient appears to be unconscious and engages in repetitive movements of the hands and feet.

Sleep is in general challenging. At least 3 nights out of the week the patient will stay awake until midnight or 1AM, only to wake up around 3AM and stay awake for the rest of the night. The patient can sometimes run around in the middle of the night, exhibiting an excess of energy. The patient’s mother will sometimes take her out for a car ride, which helps the patient to relax. If the patient has been up all night she will sleep during the day.

Difficulty concentrating and hyperactivity. The patient has a difficult time focusing when working with a therapist, or when being instructed in any way. She is often hyperactive, especially in the morning and at night. The patient loves to run and move very quickly. When she is running she can manoeuvre her way through anything, e.g. moving around tight corners very quickly and with ease.

When the patient is walking, however she is very wobbly and unstable. When she is hyperactive she can engage in repetitive behaviours. When at the playground with other children, for instance, she will do the same thing over and over, such as running from one end of the park to the other, or repeatedly going down the same slide.

The patient likes to climb on things, such as the tables, chairs, and windowsills in the house. When she was young, she fell from a table, hitting her chin and cutting her tongue. Since that time the patient usually has her mouth open, with her tongue partially sticking out. As a result, there is a tendency for the patient to drool.

Stimming is characteristic of the patient’s behaviour. She will almost constantly be making humming noises and moving her arms and hands in seemingly involuntary ways.

Fine motor skills. The patient was described by her mother as very clumsy. She can easily fall. There is poor muscle tone in her hands, making it difficult for her to point and to manipulate certain objects. Her constitution is tall, thin, and wiry.

When she is walking, her mother reports, it is as if she were on a string and was being pulled along. Sometimes she will almost need to be dragged when walking. She is much better when moving quickly, but this is hazardous as she acts in a way which suggests that she does not sense danger. The patient can, for instance, run onto the road if the front door is left open. She likes to escape the house and in general run away at any given opportunity.

Quick to anger, easily frustrated. The patient’s anger is expressed most regularly if she has to wait to be fed when she is hungry. If the child sees that her mother is preparing a meal, she can wait patiently. But if there is some delay e.g. a phone call that must be taken which postpones meal time, she can become extremely angry.

There has been a history of biting the mother in fits of anger. The child can also throw her body onto the floor when she is angry and slap the floor in rage. The patient can also get upset when she is told to do something that she does not want to do e.g. being told that it is time to leave the playground and return home. She may hum the melody to a song in a way that is expressive of her anger. She may hum a melody and speed up the tempo as another means of expressing her anger.

General emaciation with a clearly distended abdomen. The patient’s arms and legs are noticeably thin, and the patient appears to be emaciated. However, she has a clearly distended abdomen. The patient has a voracious appetite, and can easily eat as much as her parents do.

Her appetite has always been voracious. However, the patient cannot eat solid foods – when she is given solid foods she appears to be choking. It is not clear if she dislikes the texture of solid foods or that she does not know how to properly ingest them. There are no other digestive issues.

Eczematous eruptions on the face. The patient experienced severe eczema as a baby; she would scratch the skin off her face because of the intense itching, and as a result her mother had to have her wear mittens.

Dairy was removed from the diet and the eczema went away. However, at the time of our consultation the eczema was coming back, especially on the cheeks. Dairy is not totally absent from the diet but it is consumed only very minimally.

Other Considerations:

During the consultation the patient was constantly humming and making noises. Her mother reports that she is exceptionally musical. When there is music playing she will move up and down and will have a smile on her face. She will often go to the piano in the house to discover the key signature that the music she is hearing is composed in.

If the patient hears something that is off key, she will go to the piano and correct it. When she hums a melody she is always on key, and she will regularly hum the melodies of actual songs with great accuracy. The patient does have musical preferences, and will make it known if she does not like a particular piece of music.

The patient has a similar fascination with numbers and likes to count. Her mother explained that she is very intelligent but that it is as if there are too many things simultaneously going on in her mind. As such, it is very difficult for the patient to direct her attention and focus in on something specific.

The patient now has a fear of loud noises. When she hears a loud noise she will hide her face, put her hands up in the air and over her ears, cover her head with her hands, or she will run to her mother and want to be held. She is also intolerant of taking baths; showers are somewhat less problematic, and it took her a while to be able to go underneath the stream of water in the shower.

She cannot stand having her hair combed, and also has a difficult time with having her teeth brushed or nails cut. She does not tolerate having anything placed on her face or hands (such as a face mask or winter gloves).

The mother’s pregnancy was uneventful. There were no recurring or significant dreams during the pregnancy, or striking food cravings or aversions. Nor were there any traumatic events that transpired. The labour was difficult and lasted for 28 hours.

The mother was given an epidural during the delivery. A c-section was eventually proposed, but ultimately was not necessary and a vaginal birth took place. At around 5 months, the doula noted that the child had very low muscle tone.

The following rubrics were used to analyze the case:

MIND – DEFIANT MIND – IMPATIENCE

MIND – DEVELOPMENT OF CHILDREN – arrested

MIND – FEAR – noise, from

MIND – GESTURES, MAKES

MIND – GESTURES, MAKES – hands; involuntary motions of the

MIND – MUSIC – desire for

MIND – NIGHT

GENERALS – CONVULSIONS – heat; during

GENERALS – CONVULSIONS – night

GENERALS – CONVULSIONS – epileptic – night

GENERALS – DEVELOPMENT – arrested

ABDOMEN – DISTENSION STOMACH

APPETITE – ravenous

EXTREMITIES – AWKWARDNESS

MOUTH – SPEECH – difficult

SLEEP – WAKING – night

Treatment Plan and Health Assessment:

This is a deep case and the initial prognosis was unclear. However, the case presents us with several strange, rare and peculiar symptoms which helped to lead to a clear first prescription. The remedy given to the patient was Bufo Rana 30C, 10 drops once a day. In addition to the rubrics presented above, which lead to the consideration of Bufo, the following small rubrics helped to provide confirmation of the remedy:

GENERALS – EMACIATION – accompanied by – Abdomen – distension of (Bufo is the only remedy)

MIND – INTELLIGENT – narrow field; in a (Bufo is the only remedy)

MIND – MUSIC – desire for – children; in

Bufo (scientific name Bufo bufo or Bufo vulgaris) is a remedy made from the poisonous secretions from the dorsal glands of the Common toad, order Salientia. It is a remedy often prescribed in cases of autism, epilepsy and developmental delay.

Bufo has a strong affinity for the mind and nervous system, as well as the kidneys and reproductive system. Roger Morrison characterizes Bufo patients as: “Unrefined, coarse patients who have poor control over their instinctive behaviours.

Irritable, restless” (Morrison: 1993, 76). On the mental-emotional plane, the Bufo patient characteristically exhibits “emotional lack of control, with inappropriate and easy laughter, aggression, weeping, hyperactivity or depression. Childish behaviour, often with depravity and stupidity. Angry when not understood, with a display of rage and fury” (Sharma: 2004, 117). When angry, the Bufo patient has the inclination to strike, bite, and destroy things.

It is not uncommon for Bufo patients to have issues with speech, as Frans Vermeullen notes: “Slow learning to talk” (Vermeulen: 2017, 343). The epileptic convulsions of the Bufo patient are generally worse at night and during sleep. N.M Choudhuri writes: “It is our particular remedy for epilepsy in which the fits occur during coition or are worse at times of menses and during sleep. These symptoms are almost always preceded by great irritability of the mind. The convulsions are usually followed by profound sleep” (Choudhuri: 2001, 196).

The Bufo patient may have a protruded tongue. Bufo patients tend to have a “Great appetite. Violent hunger, even after eating, esp. in evening.” (Vermeulen: 2017, 343). There may be skin problems which are coupled with neurological disturbances (ibid).  There tends to be a general aggravation when in a warm room. Bufo patients can have a great love for music, and can have clear gifts in the fields of music and mathematics. As we can see from the rubrics above, the Bufo patient may have a highly developed intelligence in a narrow field.

Follow up:

After a month on the remedy, a follow-up was conducted on September 24th, 2021.

The patient’s mother reported that she has not had not had any seizures since starting on Bufo.  Her concentration and attention has noticeably improved. Previously when the patient was doing therapy she could not be engaged for more than an hour. After starting on the remedy her mother reports that she seems ‘zoned in’ and is able to participate in therapy sessions for up to 4 hours at a time.

Whereas previously the patient would wake up regularly and not be able to fall back asleep due to her hyperactivity, she is now able to sleep through the night on most nights.

Bowel movements have become more regular. The mother reports that there were at times issues with constipation, which she is no longer noticing.

The patient still exhibits hyperactive behaviour as before, but she is now able to concentrate on a task when assisted. If she is actively engaged and involved in an activity with someone then she will be able to focus on it. Previously this was not possible.

Before starting on the remedy the patient would have tantrums every day. She still can get frustrated, and will whine and cry, but she does not get angry as before. The frustration comes through especially around the issue of food. The patient is starting to understand that she will sometimes have to wait to be fed and is showing a great deal more patience in this respect.

There have not as yet been any words or verbalization. However, she does try and say her name if she sees it printed on the white board in therapy sessions.

The patient’s already voracious appetite seems to have increased. Her mother reports that she will have a big dinner and then have dessert immediately after that. Though her appetite has increased since she started on the remedy, her weight has not.

The eczema on the face has also improved.

The patient has improved significantly on both the mental and physical planes, especially with respect to her seizures, capacity for attention, and behavioural patterns. Given these improvements the decision was made to continue with Bufo but in the 200C potency. Given the deep and complex nature of the case, 10 drops once a day was decided upon as the posology.

As of the time of writing, there have been no further detailed follow-ups with the patient, due to time constraints of the family. I spoke with the patient’s mother briefly in December of 2021 and she reported that the patient is still improving in all of the above areas. She also noted that the patient has, on a few occasions, started to speak one word at a time.

About the author

Victor Cirone

Victor Cirone is a practicing clinical herbalist (RH, OHA) and homeopath (class of 2022, CCHM) based in Toronto, Canada. He is a co-founder of Everything Herbal (www.everythingherbal.ca), a website dedicated to the promotion and furtherance of traditional systems of healing. His work in the healing arts is inspired by the writings of Rudolf Steiner and the tradition of anthroposophical medicine, as well as depth psychology.

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