A female aged 32 presented with vertigo  that had steadily worsened over the past 3 to 4 weeks. She often felt dizzy while walking and said she had experienced it on her way to see me. She said she was experiencing the sensation at that moment whilst sitting and was finding it difficult to focus on me or one object. She described it as “things went from as if they were moving to becoming hazy”. The episodes were becoming more frequent and could come on at any time of the day, standing sitting or lying. There were no modalities, pains or other marked sensations with the vertigo.
She said she had been suffering from constipation since travelling overseas over one year ago. She said that she only had a bowel motion once a week, which suited her because she needed to be up very early each morning for work and had a busy schedule. Her stool came usually on the weekend. When the stool came it was normal, no pain maybe just a larger amount. She had tried laxative treatments and enemas in the past but they had made no difference.
She worked in an office. She sometimes competed in triathlon, so she trained every day. Her ‘rest’ day consisted of lighter exercise like jogging or playing a game of basketball. She said she feels really bad if she misses training and will even train when she is sick.
She is extremely health conscious and has a diet containing plenty of vegetable fibre, meats and fruits and drinks plenty of water. I discovered that she snacks almost constantly through the day between her regular meals, snacks consisting of muesli bars, nuts, small tin of tuna etc. She carries these snacks with her whenever she is out and about. She said she is often worried that there won’t be food nearby. She said that she didn’t like the thought of her stomach feeling empty because it would rumble such that others could hear (borborygmi). Her menarche was at 18 years and it has always been infrequent, sometimes only appearing every 2 or 3 months. No other symptoms. She is tall and built like an endurance athlete. She is married without children.
The following symptoms were selected that best described the presenting symptoms.
Sensorium (consciousness), Vertigo (dizziness, giddiness etc.) (815)
Digestive Dysfunctions, Evacuation & Stools, Constipation 1418)
Female genitalia, Menstruation, Menses, infrequent (menses delayed; cycle too long) (515)
Modalities, From Situation & Circumstance, Exertion, physical, amel. (+ amel. Dancing, Running, Walking quickly) 11915)
Modalities, From Situation & Circumstance, Eating, before (on an empty stomach, fasting) 11897)
The repertory I use is the TBR 2 which has been newly updated and revised from Hahnemann’s and Bõnninghausen’s original manuscripts by George Dimitriadis and the Hahnemann Institute in Sydney. It yielded the following remedies:
When I read Sepia in The Chronic Diseases there were 16 vertigo symptoms, including symptom 90: Vertigo when walking, as if all objects were moving. And symptom 99: Dizzy vertigo, every afternoon from 4 to 6pm while sitting and walking. No other Materia Medica could give me such detail and confirmation that Sepia is capable of producing this vertigo, as well as the constipation, the infrequent menses, general amelioration from exercise and aggravation from fasting. Also, having an even grading in the repertorisation tells me that these symptoms in combination are only found in Sepia.
Sepia 0/1 (Q potency) was given to be taken once daily. Return in three weeks.
When the patient returned, she reported that the vertigo had disappeared. The remedy had started to work in the first few days with gradually fewer episodes of vertigo. She also had more bowel movements now, about every three days.
Continue Sepia 0/1 daily. Return in 4 weeks.
She continued to improve with regular bowel motions and no more vertigo. She had also had her period over a week ago, so I asked her to continue on the medicine and return in another 4 weeks. When she returned, she reported that she was now having a regular menstrual cycle and other symptoms were still good. She was less stressed about having the snacks with her as well as not being so hard on herself if she missed a training session. On parting she said that she felt more feminine. “I feel like my breasts are finally developing” (she had been quite flat chested). I gave her a refill of the Sepia and told her to continue taking it.
I lost contact with this patient due to distance, but a friend of hers informed me that she was fine and well. She has since had one child and is happy and healthy.