I met this very soft spoken, reserved man at his home in mid August, quite a few years back. He was then 85 years old (I’ll call him Malcolm) and living with his wife of 60 years, in their own home. Malcolm had Shingles on the right side of his face, from his temple, across his cheek to the chin. It had started following complications from a root canal procedure one week earlier. Part of the eruption was covered in a dry brown crust and other areas were moist and oozing a clear fluid. The side of his face affected appeared swollen.
He had a history of acid stomach with burning and pressure and frequent belching since he was a young adult, treated with antacids. High blood pressure was controlled with medication since 1981 and type 2 diabetes since 1983 was controlled with diet and medication. He was diagnosed with stomach cancer in 1989 and was treated with surgery and Chemo therapy. He refused any further treatments after the first one.
On first impression he was very restless, hands and feet constantly moving, small fidgety movements, straightening his pants, his sleeves. It was a warm day and he was wearing a long sleeve flannel shirt and a cardigan. Both the edges of the sleeves and collar were worn out, yet very clean and pressed. He was very thin, quiet, very polite.
The clients own words:
Laughs, it looks so bad I shouldn’t go out in public. Dr. says it’s shingles. Didn’t know you could get it on your face. Not sleeping well. Family is coming to visit this weekend. I don’t think I am fit for company; it is probably better if they don’t come. It is too much, I get very tired.
At night the pain wakes me up. I wake up around 1 or 2 and just lay there can’t go back to sleep. Keep thinking what is going to happen. The medicines aren’t working. There’s no use in taking them. Sometimes I get up at night, just walk around the house. Just can’t settle down. It burns and stings, hurts all the time. I should be ashamed at how the yard looks. What the neighbors must be thinking. But I start to do some work and the pain gets worse, o so bad, just terrible and then I get so tired, so weak. I’ve just got to lie down. I probably should get a man to do the garden work for me, but how do you find someone you can trust? You don’t want a stranger to come in and see your mess.
What makes the pain better?
I use a hot washcloth; that helps a little. Well I can be hungry but nothing looks good. Stomach has terrible burning. I don’t eat very much. After I eat, the burning and belching is bad. I eat then get pressure, belching helps a bit. I just have to get up and move around a bit. I like coffee, I like it hot, settles my stomach a little.
Low back hurts sometimes I’m old, just a little stiff, takes a while to get going. I have high blood pressure and diabetes, I am supposed to take medicines for it, I don’t like it, but I guess I have to do it. That’s what they all say.
At this point he is no longer willing to talk to me and excuses himself. I talk with his son.
The son reports: “He gets very tired, then he’ll lie down for a while. My dad is very restless. When the family gets together he never sits down. He’ll say he’s hungry and that the food sure smells good, but then after a few bites he’s done. Then he’ll get up start cleaning the kitchen and make coffee. I can’t remember the last time I saw him drink a whole glass of anything.
He was an officer in the navy for 40 years, extremely responsible. Always very precise, he is always cleaning and straightening things. He even combs the fringe on the carpets.”
A homeopaths dream……..striking symptoms of burning pain, better from heat, combined with extreme tiredness yet also extreme restlessness. And not ever drinking more than a few sips at a time. Maybe you can guess?
I did not expect any significant change in the diabetes or the high blood pressure. The goal was to help heal the shingles eruptions and avoid the post neuralgic pain that is all too common. I also hoped to ease the stomach discomfort and for him to have overall more calmness and less of a feeling of exhaustion.
Repertorization from MacRepertory Complete Millenium Repertory
FACE; ERUPTIONS; herpes (K368, G310) (145)
MIND; DESPAIR; recovery, of (K36, SRI-394, G28) (70)
MIND; FASTIDIOUS (K42, SRI-472, G33) (52)
MIND; MOOD; repulsive; treatment, every; sick, in spite of being very (3) : ars., caust., nux-v.
STOMACH; PAIN; burning; eating; agg. (K516, G439) (30)
STOMACH; ERUCTATIONS; ineffectual and incomplete (K491, G419) (69)
Arsenicum clearly comes through!
Arsenicum is known for being chilly and seeking warmth. It is especially known for it’s burning pains ameliorated by heat. It covers the shingles eruption. The fastidiousness, fidgeting and constant motion. But most characteristic is the extreme tiredness and weakness the client complains of during any of his pains. MIND; RESTLESSNESS, nervousness; general; fatigue, with (1) Arsenicum is the only remedy.
From Tyler’s Drug Pictures:
“appalling anguish, fear, and restlessness, combined with weakness and collapse…”
MIND; DELUSIONS, imaginations; reproach, has neglected duty and deserves (K31, SRI-343, G25) (3) This addresses his sense of neglecting his yard, and his concern for what the neighbors may think.
REMEDY CHOICE: Arsencium. Because he is older and frail I choose a lower potency (30C) and a water dose. 2 pellets in water – 1 tsp. To alleviate the itensity of the pain and skin eruptions I felt it was important to repeat the remedy 2x over 12 hours, one dose at bed time and one the following morning. The pain lessened by the next morning.
” I’m a little better, thank you. Pain is a little less. The skin is drying, the blisters are going away. Not so swollen. Eating is a little easier. It is getting better, I’ll be alright.”
After 2 weeks the eruptions were drying up and healing, burning pain was gone, he was sleeping a little better, still woke up at night, but not as restless. His eating was a little improved, pressure and belching remained, burning was not as bad. We scheduled follow up visit. The remedy had not been repeated since the first doses and no remedy was given.
By mid September, 4 weeks after taking just 2 doses, his skin had healed very well. Only some discoloration and a few dried scabs were left. My hope for him of avoiding the post neuralgic pain had come true. He was still waking up at night with worry, but able to stay in bed until about 5 am. His stomach still bothered him and his appetite was not great. The restlessness was returning, but still better than before.
It was time to redose the Arsenicum 30c – 2 pellets in water 1x.
Another month later:
“I feel good. My face is completely well, skin is good and it doesn’t hurt at all. Hasn’t hurt for some time. I sleep better, I still wake up but go back to sleep. My stomach still bothers me some. It was much better for a while after I took the medicine last time, then it started changing. “
We talked about limiting coffee to 2-3 cups per day and redosed Arsenicum 30c – 2pellets in water. We talked about when he should take the remedy so he could take care of his restlessness or the stomach discomfort on his own.
Another 2 months later:
“It was good advice to drink less coffee. Stomach is better, I have been eating more. I don’t really need a lot. Food does taste better, I don’t feel so terribly full, the pressure is less. The feeling of wanting to belch is much less. Still don’t like vegetables and avoid them best I can. Sleep is alright. I still wake up but can go back to sleep. Wake up around 1 o’clock, sometimes later and get up by 5.”
Then some months later I received a phone call from his son, that he had received news that his brother was very ill. He was pacing again and extremely exhausted right after the phone call. The bad news had upset him and reactivated his state. It is very interesting and not uncommon that clients do not corelate symptoms returning due to an emotional upset as a “real” cause for bodily symptoms. I was glad he had called because once again, another dose of Ars 30c in water created change overnight.
‘I am better. We are all getting old. My brother is very ill. I worry for him. But I am better now, not so tired. My stomach stopped hurting right away after the medicine. I am eating better, I don’t need much anymore. I am less worried. I worry that everyone is safe. I still wake up at night. I feel less nervous, I can sit and visit with family. I enjoy their company.’
After many years and clients I decided to write about this case because this was the my first case that so clearly let me experience the elusive gratification of aphorism #3:
“If the physician clearly perceives what is to be cured in diseases, that is to say, in every individual case of disease (knowledge of disease, indication), if he clearly perceives what is curative in medicines, that is to say, in each individual medicine (knowledge of medical powers), and if he knows how to adapt, according to clearly defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient, so that the recovery must ensue – to adapt it, as well in respect to the suitability of the medicine most appropriate according to its mode of action to the case before him (choice of the remedy, the medicine indicated), as also in respect to the exact mode of preparation and quantity of it required (proper dose), and the proper period for repeating the dose; – if, finally, he knows the obstacles to recovery in each case and is aware how to remove them, so that the restoration may be permanent, then he understands how to treat judiciously and rationally, and he is a true practitioner of the healing art.”
It is not often that our cases fit a remedy so precisely and so clearly, but when they do, it is quite amazing to be witness, and to experience a remedy in it’s full personality and sphere of healing possibilities. Malcolm, even with his few words taught me to trust in homeopathy, the clients state, the materia medica…and that sometimes a person with a disease is really that easy to help with homeopathy.