Great Expectations

A young man aged 28 came to see me for his Psoriasis. It started when he was 6 years old. By age 14 it covered about 80% of his body. The appearance is thick and leathery. All of his skin is very dry. In the winter it is worse, always aggravating with the start of the heating season. Then he would also develop cracks of various sizes and depth on bends and in folds, or sometimes other places. There is very little itching since his previous homeopath had told him to avoid dairy products, which he sticks to most of the time unless on holiday. The psoriasis itself, however, did not improve on a dairy-free regimen. For several years, from the start of the problem until the age of about 15, his parents took him to medical doctors and he had tried many different emollient and steroid creams. These did not help and so at about age 16 he stopped using any creams except Vaseline. Since all these symptoms and modalities are common for psoriasis, the lesion itself therefore did not give me much to go by.

I then found out that in his late teens, about age 17 or so, he began homeopathic treatment and continued this for about 2 years. This brought significant improvement, because the itching stopped and the lesions reduced to covering only about 50% of his body. His trunk cleared almost completely and his face, scalp and neck improved so that using Vaseline on those areas enabled him to look “normal”. As an added benefit, he stopped using any pharmaceuticals at all. He does not really get sick, except the occasional mild cold (no cough even). After 2 years, he stopped the treatment because the skin seemed to improve on its own. For several years, until a few months ago, it continued improving so that only his arms and legs as well as 2 patches on his trunk remained affected.

In spite of the improvement in the psoriasis, the newly growing healthy skin came back having lost its pigment. On his hands he had bright pink patches and in other places he developed much lighter pigmentation than his normal colour. A doctor had told him this was vitiligo.

He had brought with him an A4 sheet of paper on which he had recorded in meticulous and delicate handwriting the programme the other homeopath had put him on. It was an extraordinary sight. Not only was this the original exemplar he had kept all this time, but also it was an exact record of dates, times and remedies taken for several months, all squeezed onto one sheet. It seemed fastidious, to say the least. Unfortunately for me, the only thing that was missing from this splendid piece of information were the remedy names! However, he could tell me he was given one remedy for his immunity, one for feeling acutely stressed and one for the psoriasis itself. Not much help, except I concluded that he must have been given a nosode, a totality and a lesion remedy. When I asked him about “acutely stressed”, he could not explain much. He said the homeopath thought he might be stressed, but he himself did not feel anxious or stressed beyond “everyday, normal things” such as traffic jams etc. I tried to find out more, but did not get anywhere with this line of enquiry.

I then took all the generals – excellent sleep, perfect digestion (like clockwork), very good energy, average body temp, no sweating unless exercising, and a reasonably good diet. I have to admit, I did did not expect too much with regards to food quality from a young bachelor, but he prepared most of his food himself and never had ready-made meals. At weekends he ate one cooked meal per day at his mum’s who lives just round the corner. Chatting away about the diet, I came across the first peculiar detail: this man can go without food all day. He drinks a normal amount of bottled water during the course of the day and then only gets hungry in the evening when he cooks himself a meal. The sandwiches at lunchtime are just to have something to do, he can easily do without and does so sometimes. Looking at him, he is reasonably tall, normal weight and looks well in himself.

One thing I noticed almost immediately was that he seemed to be trembling most of the time. His voice trembled and his hands trembled. It was a very mild tremble, almost unnoticeable, but I thought it was peculiar for someone to be anxious all the way through a 90 minute consultation. Normally people settle down after a few minutes. Because of this noticeable tension, I investigated his mental emotional state. Interestingly, there was nothing to be found. No trauma, no bereavement, no particular experiences that might explain the psoriasis. I concluded he must be very shy, a timid person, to be trembling so much.

There was also no evidence that vaccinations had anything directly to do with it, or any other medical procedure. This man was emotionally stable, had a good job which he enjoyed, a loving and supportive family and had nothing to say that could suggest a mental/emotional aetiology. The only thing I could find was a slight apprehension about meeting new people due to his psoriasis – he felt as if they might think he was contagious. He said it did not trouble him too much, as he was used to it. All this, together with strong religious tendencies (he is a practicing Catholic), led me to open the case with Leprominium in daily water solution, according to Organon 6. The idea was that the previous homeopath had treated him for 2 years and probably given him all the nosodes under the sun, as well as Graphites and Petroleum.

A month later he still trembled just as much, and the skin had not improved at all. During the consultation we covered the usual generals and I tried to get more out of him in the way of emotional problems, but there simply was nothing. I covered girlfriends, mother, siblings, father, etc. – nothing. Stress at work, performance pressure – nothing.

And so it carried on for several months. He diligently turned up, but reported no change. He trembled. I prescribed.  Carcinosin, Cortisone, Thyroidinium, Syphilinum, and lesser remedies until one day I gave him Silica as a last resort. Luckily it worked, although far too slowly for my expectations and his vitiligo did not change. We went from LM1 to LM10. His Psoriasis was clearing slowly all this time down to perhaps 30% coverage. I wanted to speed things up a bit and decided he could take a dry dose of 200c. But with the 200c dry dose there was an aggravation. The first one! All the other remedies were wrong but brought no aggravation and this one was right and aggravated. I rejoiced, thinking there would be a cure next. Alas, no cure. He stabilised on exactly the same level as where we left off before the 200c.

At this point I was at the end of my personal homeopathic abilities. Why would the LM be good and the 200c be no good at all? Sure, I could go back to LMs, but somehow it did not make sense. Yet another miasmatic block? I also believed there should be a faster improvement after all this time. I began suspecting worms or hidden maintaining causes, such as electromagnetic radiation.

Since I am a diligent sort of person, I went through all my notes of this case. This was a good course of action, as in the second consultation I had written something peculiar. This man had come back after the first month and had asked me “what do you expect to happen?” I thought it strange at the time. It was said as if I -the practitioner- was expecting him -the patient- to perform to a certain standard. I suddenly realised what this question was about. He was worried that his performance was not fulfilling my expectations!

Now I knew the remedy: I remembered Sankaran’s profile of Calcarea silicata in his book “Soul of Remedies”.  According to Sankaran, Calc sil suffers from expectations placed on him. Interestingly, Sankaran describes the remedy within Indian society and my patient was indeed Indian. Of course, Calc sil is a psoriasis remedy and so it was perhaps inexperience which did not lead me to it earlier.

I thought that the rest of his profile was a reasonably good match too and so we started on 30c dry doses, but quickly worked our way up to 50M within three months. The last time I saw him, his Psoriasis had reduced by half within one month after the 50M single dose. There are just the traditional places left now: extended areas around elbows, wrists, knees and ankles. Most importantly, the vitiligo patches are returning to normal colour too! He has recently taken a 100M single dry dose and I am waiting for the results at the next appointment.

I imagine the reason the pure Silica worked in liquid potency is because the patient has a very high vitality and the highly diluted Silica was similar enough for his vital force to respond to it. When given in a dry dose, which is stronger, the vital force did not consider it similar enough and felt the need to point this out to me. So I needed something almost Silica, but with a special tweak. Calc sil is not well represented in the main material medicas (although I found a good profile in Farokh Master’s childrens’ book) and so perhaps I am excused for not recognising it straight away.

I have since used it in another skin case, but this time for severe acne in a young woman. She suffered from acne since the age of 7 and nothing had helped at all. I was about to give her Silica, when she told me that she had a bout of insomnia before her first year exams at university. I asked her what kept her up and the answer was “Since they were my first exams, I did not know what depth of knowledge was expected of me.” I gave her Calc sil and her acne was cured within 3 months. No scars were left either.