Clinical Cases

Going with the Flow: A Case of Niccolum

The author describes a case of Niccolum based on themes from the periodic table using the MICH method.

Homeopaths: Dot Wojakowski, Brenda Cockfield. Montreal Institute of Classical Homeopathy (MICH) Intern Center.

Chief Complaint

A young woman of 28 years of age was unable to swallow solid food since an incident in which she nearly choked to death. This inability to eat (a sort of eating disorder) had gone on for three months. It occurred at a time in her life in which she felt things were moving too quickly, not “at her own pace” at a “sequence I cannot follow”. She had recently moved to the city from another province for her studies and felt homesick and disconnected to her new home.

Her physical symptoms centered on complaints pertaining to the neck and throat region. She felt tension externally while internally there was inflammation and a sense of a lump inside, particularly on the right side. When the client made an attempt to consume any food with texture or of a solid consistency, the throat would constrict, become blocked leading her to choke and be unable to swallow. Consequently she was consumed by a fear of dying from choking and reduced to eating an exclusively liquid diet. She also had difficulty sleeping, waking easily because of anxiety.

She presented as someone who was very sensitive, who had spent some time exploring who she was as a person, particularly as an artist. Initially, she seemed reserved and timid yet when she did speak she was incredibly expressive and descriptive. There was a quiet strength about her. She was also very observant of others. She said she was anxious and frustrated but it was a quiet frustration; it held a lot of emotion and tears.

Kingdom & Remedy Differentiation

While she often spoke of the need to adapt, there were consistently themes of performance in her work, security and home. And in all of these areas she frequently spoke of her experience as feeling either connected or disconnected (complete or incomplete). There was always a vulnerability that she felt she needed to defend and protect, especially since that defence could easily “crack” or “break”.

In her work, especially her creative work, she endeavored to not show any weakness – or any “break”. Nor did she want to feel “forced” to do something. When she did feel as if she was being forced, it felt as if it was a “break in the flow” and a “break in continuity”. For obvious reasons, the client was unsurprisingly worried about nourishment. However, the theme of nourishment also stood as a metaphor, something that went beyond the physical act of eating. It was critical for the client to nourish herself and she experienced it in all areas of her life: the sensation of nourishment as home, community and security. Nourishment also brought a feeling of “connection” and a sense of “flow”.

For all these reasons, it appeared the client was in need of a Mineral remedy, specifically from Row 4, which emphasizes issues of security, task, threat, job and vulnerability.

Another remedy was briefly considered, specifically Ferrum. However, this remedy did not fully encapsulate the client’s internal and global experience. Niccolum was selected given its Materia Medica as described by Frans Vermeulen and Guy Loutan as well as its position in Column 10 and its themes of success, failure and achievement as articulated by Rajan Sankaran and Jan Scholten. Niccolum yearns for simplicity and is sensitive to things that can suddenly change or cause a sudden rupture. Niccolum hopes life will always continuously flow from one to thing to another, guided by one’s own instinctive sense of timing and creativity. And if things do not move with continuity, it feels as if it is a break in the flow of life. Niccolum requires stability and suffers greatly from transitions; they only exacerbate a sense of insecurity. As a metal, Niccolum brings toughness to alloys, particularly stainless steel. It is also frequently used as a catalyst highlighting its inherent quality of being sensitive to breaks.

Rx Selection

Niccolum 1M


Coughing, Dry, cough, midnight until 4 AM

Throat, Choking

Throat, Constriction

Throat, Pain, right side, inflammation

Throat, Pain, on swallowing

Throat, Pain, when talking, Agg.

Throat, Strangulated sensation

Throat, Swallowing, difficult, liquids only, can swallow, but solid food gags

Larynx, Pain on talking

Sleep, Disturbed, from anxiety

Mind, Fear, phobias, death of

Mind, Homesickness, nostalgia, general

Additional psychosocial “homework”

It was suggested to the client that she begin to notice when she felt as if things “flow” and when she felt as if “blocked” or felt “obstacles”.

Follow-up 1/Session 2:

4 weeks after Nicc

In the first follow-up appointment, the client announced that for the first time in four months, she was able to consume a non-blended soup that contained diced, cooked vegetables. Feeling less anxious, her sleep had improved and she was feeling more energetic.

However, in this session, we became sidetracked by her vivid description of flow and the obstacles that hinder it. Coupled with her sensitivity, we concluded that she was now expressing another remedy. It appeared to be confirmed by some rubrics, as well as the presence of what seemed to be a passive and active reaction to situations and her compensation. We turned to a Plant remedy of the Cruciferae family: Sinapsis alba 200K.

Follow-up 2/Session 3:

8 weeks after Sin-a

The client reluctantly admitted that she was still unable to eat any solid food. She felt helpless and was anxious about her home and the uncertainty of school and its demands. Her physical frustration of being unable to swallow was heightened by her sensation of being squeezed into a rigid structure that is school. She was always searching for stability and security. There was a desperate longing for continuity and a need to have a sense of harmonious flow, both in terms of eating as well as in her work.

After her session, we realized that the previous remedy of Sin-a, most likely was a prescription that only covered her local experience rather than something that is global. It neither adequately covered all of the client’s feelings and challenges nor did it connect to her deep-seated insecurity and need to perform well.

And so, the client was prescribed the original remedy of Nicc., this time at a potency of 200K as it was surmised that she needed to integrate the emotional aspects of her experience. It was important that she ground and assimilate (“digest”) the “choking incident” so she could better understand its significance in her evolution as an individual, artist and therapist-in-training.

Follow-up 3/Session 4:

8 weeks after Nicc

There was ample improvement on the physical level yet the themes of connections, continuity, breaks and security still ran through the case. She was happy with her new home and was actively building a community. The client, a textile artist, also made a beautiful connection to her chief complaint when she described the act of making art as something that one digests and internalizes. The remedy, Nicc 200K, was repeated.

Follow-up 4/Session 5:

7 weeks after repeated Nicc

The client had resumed a normal diet. She was able to eat everything except nuts. Things in her life felt as if they were moving “at her pace” and she felt that she had created “better boundaries” with friends and colleagues. Approximately once a week, she would still wake up with coughing and/or choking. While she did endure a severe aggravation one night of severe choking, the experience felt as if she finally integrated the initial trauma and had gone through “a rebirth”. She was “ready to give birth to something huge”. Her Master’s thesis awaited and seemed daunting yet nonetheless she felt up to the task and remained optimistic.

The remedy was not repeated although a bottle of Nicc 200K was given to the client to take only if needed.

Montreal Institute of Classical Homeopathy

About the author

Dot Wojakowski

Dot Wojakowski graduated from Montreal Institute of Classical Homeopathy in May 2009 and now practices homeopathy, as well as naturopathy. You can learn more about Dot Wojakowski and her practice at:


  • Dear Author,

    I greatly apprecied the method to enclose the patient, at the beginning, in a kingdom way.

    Thank you for your contribute

  • It’s good that we are not too proud to say what doesn’t work. There are some great charts in the back of Vithoulkas’ Science of Homeopathy book that reinforce the prescribing process you have used in htis case.
    nice going!

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