Clinical Cases

Natrum mur. in Acutes

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Introduction: Acute cases are exciting, because one can experience the magic of homeopathy and be totally convinced of its power. Below are cases to help you work out your own analysis and see what remedy you come up with. Then you can compare with the analysis and remedy given. It always helps to sharpen ones acute prescribing skills as that’s where one can easily convince people that homeopathy works!
CAUTION is the byword for all acute prescriptions, as over the long term we have to be vigilant about suppression or superficial palliation with the acute remedy. Its important that the patient is followed up for long term constitutional treatment.

CASE 1. 65yr old Man, with Acute Indigestion.

Mr. DBS called me one day and complained of indigestion which included a feeling of weakness and thirst for small quantities of cold water. He had vomited 2-3 times immediately after eating, but without any preceeding sensation of nausea. Occassionally he felt nauseated after eating in the afternoon. With this he felt reluctant to eat. Based on these symptoms, he was prescirbed Ars Alb and said he felt better with 2-3 doses of Arsenic album 30C. No vomiting, his appetite was back and weakness mostly gone.

4-5 days later he called bak to tell me that inspite of having a normal stool in the morning, he had a second soft stool with offensive flatus in the evening. He felt a complete loss of appetite with flatulence and distention in the abdomen that made him very uncomfortable. This sensation was better after the evening stool, which also improved his appetite and he was able to eat a little bit at night. Another symptom he mentioned was frequent eructations. These eructations were very small and felt incomplete. They increased the uncomfortable sensation in his abdomen. The only concomittant at the start of the second set of symptoms was a drowsiness which made him sleep almost through the whole day.

Follow Up:

With one dose of the remedy in 30C, he felt completely better. His energy improved, the stools were normal, appetite improved and there was no distention or eructations any more. He called me the next day telling me he felt very fit and completely cured of this digestive problem that was troubling him over the last 10 days.

Analysis: (Complete repertory)

ABDOMEN; FLATULENCE; stool; during (K548, G467)

ABDOMEN; DISTENSION; stool; amel. (K545, G465)

Soft stool X Evening: aloe, alum., ars., bor., bov., bry., calc., calc-p., calc-s., canth., carb-an., caust., chel., chin., choc., colch., cycl., dig., dulc., gels., ign., iod., ip., iris, kali-c., kali-chl., kali-n., kali-s., lach., lept., mag-m., mang., merc., mez., mur-ac., nat-ar., nat-m., nat-s., nat-sil., nuph., nux-m., ph-ac., phel., phos., pic-ac., plan., podo., psor., puls., sang., stann., stront-c., sulph., thuj., verat., wye., zinc.

Appetite wanting X Stool >: abrot., acon., agar., aloe, alum., am-m., ant-c., ant-t., ars., ars-i., asaf., aur., bar-c., bism., bor., bov., bry., calc-p., canth., caps., caust., cham., cina, coff., colch., coloc., con., croc., cycl., dig., dulc., ferr., fl-ac., glon., guai., hell., hep., ip., kali-bi., lach., lob., mag-c., mang., merc., mosch., mur-ac., nat-c., nat-m., nat-s., nux-v., op., ox-ac., ph-ac., plb., psor., puls., rheum, rhus-t., sabad., sang., seneg., sep., spig., squil., stann., sulph., tanac., thuj., verat., zinc.

STOMACH; ERUCTATIONS; General; ineffectual and incomplete (K491, G419) (Flatulence, sensation of)

Discussion: This patient was already on chronic treatment with me for other problems. He had responded very well to a few doses of Staphysagria and most of his problems had disappeared over the last 6 months. He continues to be helped in his chronic problems with Staphysagria, so one could safely state that it is his Constitutional remedy.

When Nat Mur came up on the acute analysis, it was a bit of a surprise to me as I have not known Nat Mur to have this type of presentation. His quick and permanent response obviously meant that it was a very well indicated similimum for that state.

Though I have often seen Nat Mur come up in relationship to Staphysagria as a “Remedy that Follows well”, and is often complementary to it, using it as an acute instead was new to me. It reminded me of the need to remain open and unprejudiced about all remedies and their action. Always, we need to take the presenting characteristic symptoms and modalities for analysis with NO preconcieved notions when making a decision about the indicated similimum.

Case 2: Boy of 10yrs. with ?Typhoid fever

SD had developed an “upset tummy” and began to feel very weak. He was thirsty and did not feel like eating anything. He felt a frequent urge for stool. His stools were loose and immediately after the stool he felt drained and very weak. He would pass stools mostly during the night, waking from his sleep with the urge. Sometimes he would (involuntarily) pass stool in his pants before he could reach the bathroom in the dark.

During the day there were no stools, instead he would vomit more frequently. The slightest drink of water or any fluid would increase his nausea sensation and he would vomit 10-15 minutes after having anything. He felt weak after vomiting. He had episodic abdominal pain which was relieved when he passed very offensive flatus.

With this he was very chilly and prefered to lie down all the time. He had an intermittent low grade fevere (about 100C), felt cold and wanted to cover at that time. He did not want the fan and preffered to lie down quietly. He looked pale and thin and quite run down. His tongue surprisingly, was absolutely clear and pink! Though he did not have much of an appetite, he wanted fried chicken and spicy food to eat. If he ate anything bland or tasteless, he would want to vomit. His mother was at a loss about what to feed him because she was afraid to give him anything oily and spicy.

On furthur questioning about the weakness, he said that he was not able to sit up with the weakness. He wanted to remain lying down and he even gave me his history lying down the whole time! Sitting was very difficult for him to do and increased the weak feeling. The weakness was maximum just after he passed a stool.

A week earlier, he was given a couple doses of Arsenic album 30C as his symptoms sounded quite typical of the remedy and he had done well on a previous occasion on it. He seemed ok for the next few days. Then the family ate a meal out, which precipitated the picture of symptoms described above.

Follow Up:

We repeated the Arsenic album 30C again since it came up very strongly in the analysis of his symptoms. It had helped the previous week, but it did not have any effect. We then gave him Arsenic album 200C, which modified his stool pattern a little bit but the weakenss remained untouched!

On review especially after investigating the weakness modality, he was given a 2 doses the similimum remedy in 30c, 12 hours apart. In 24 hours, his vomiting stopped, he was ravenous and wanted all sorts of exotic food to eat, especially chicken and fish. His stools continued to be loose and very offensive, but he no longer felt weak after them. Also he now had one stool a day, and none at night.

His weakness improved almost immediately after the first dose and he got out of his bed to laugh and play with his father in the drawing room. In the next couple of days, he had another 3 doses of the 30C and he went back to school feeling normal the following week.

Analysis: (Complete Repertory)

Acute Picture:

MOUTH; CLEAN, clear Tongue

STOMACH; NAUSEA; drinking; agg.; after

RECTUM; INVOLUNTARY stool; sleep, during

STOMACH; VOMITING; General; drinking, after; agg.

ABDOMEN; PAIN; General; flatus; passing; amel.

GENERALITIES; WEAKNESS, enervation, exhaustion, prostration, infirmity; vomiting; after: aeth., aloe, ant-c., ant-t., apoc., apom., ars., asc-c., asc-t., bar-c., cadm-s., colch., cupr-ar., der., eup-per., gran., guai., kali-br., lob., lyc., mag-c., nat-s., op., phyt., sang., sant., sarcol-ac., sel., verat., verat-v., zinc.

GENERALITIES; WEAKNESS, enervation, exhaustion, prostration, infirmity; loss of; fluids: alet., calc., carb-v., China, cur., ery-a., ferr., ferr-acet., ferr-ar., ham., hydr., lachn., nat-m., nuph., Ph-ac., phos., psor., sec., sep.

GENERALITIES; WEAKNESS, enervation, exhaustion, prostration, infirmity; sitting; agg.: agar., anac., arg., ars., aur., bry., carl., caust., chel., chin., cocc., colch., fago., graph., kali-n., lap-c-b., led., lyc., m-aust., mag-c., mang., merc., merc-i-f., mur-ac., nat-m., nit-ac., nux-v., phos., plat., plb., psil., ptel., ran-b., Rhus-t., ruta, sabad., staph., stront-c., sulph., thuj.

Chronic picture (in addition):

MIND; QUIET; disposition

Impatience X with Ennui: acon., ambr., amph., androc., ars., aur., bamb-a., bar-c., bor., calc., chin., choc., germ., graph., hura, hydrog., Ignatia, ip., kali-bi., lach., lil-t., lyc., manc., Mercurius, mez., mosch., nat-c., nat-m., nit-ac., Nux-v., ph-ac., plat., rhus-t., spig., Sulphur, tarent., zinc.

EXTREMITIES; WARTS; Fingers

EXTREMITIES; ERUPTIONS; Elbow; bend of

EXTREMITIES; ERUPTIONS; Knee; hollow of

Discussion with Chronic history:

Even though Ars Alb seemed indicated in the initial analysis, the general weakness remained absolutely the same. Was this another salt of Arsenic or was this a completely different remedy?

We decided to investigate the weakness modalities in more detail. Weakness, he said, was worse after a stool though it was worse after vomiting as well. The weakness did not allow him to sit up and he preferred to lie down and talk to me. With these details, the 3 ‘Weakness’ rubrics mentioned above seemed appropriate. One can see that Nat mur is in ‘Weakness from loss of fluids‘, while Ars is not in that rubric. Natrum Mur, surprisingly, was also in the rubric ‘Weakness < sitting‘!

He was already into the 4th day of this illness with low grade fever. He had not eaten anything for 4 days and was vomiting and had loose stools. He looked totally drained and toxic! This concerned me, especially with the suspicion that this could be typhoid, (there was an epidemic in the area) given the amount of weakness and the history of eating food outside. And so I decided to take his complete case history as well at this point, along with his mother.

She told me that he was a quiet boy by nature. He had a history of skin problems from childhood. He tended to be impatient with his studies. He did not like to study something he “already knew”. During exams even when he was well prepared, he brought home very average marks. This, apparently, was because he was too bored answering so many “useless” questions that he already knew the answers to! When he was bored, he was impatient. So he would not take the trouble to answer these questions in detail. He answered questions in one word (!) or only what was absolutely required in a couple of sentences, essay answers to the point! This unfortunately fetched him only half the marks that he could have got, but he couldn’t care less!

He said, if something upset him, his response was to be sad and quiet to himself for a while till he got over it. He would not like to discuss with his mother about what be was feeling, like his elder sister did. Mom said he was a “thinking” type of boy. He seemed to think very deeply about all issues and ask a lot of questions when he was learning something new till he understood it in depth. He liked being with his friends and was in the school cricket team. His cricket coach said that he played a “thinking” game.

He had eczema from childhood but it was only in the hollow of his knees and elbows. Presently he had a few warts on his fingers on the palmer aspect.

This additional history confirmed Nat Mur, which was the remedy coming up in the earlier acute history analysis. I knew now that it was his constitutional remedy as well. This increased my confidence in the remedy being able to help him right through this acute illness that was threathening to become a toxic Typhoid fever.

Just 4-5 doses of the 30C of Nat Mur and he was back in school the next week! The moral of this story is: even in serious acute infections, being aware of the constitutional remedy of a person can heal him through it, especially when constitutional symptoms and modalities are also evident in the acute condition!

About the author

Leela D'Souza

Leela D'Souza

Leela D'Souza-Francisco, MD (Hom), CIH (Cardiology) is a Mumbai-based homeopathic professional whose experience includes intensive graduate medical training at India's leading homeopathic medical institution in Mumbai, completed in 1990. She completed her MD (Hom) from MUHS, Nashik in 2008 with a Dissertation entitled "Emergency Management in Homeopathy". She obtained a post graduate MSc (Homeopathy) degree from UCLAN, UK in 2009 with a Dissertation entitled "How Can We Develop Suitable Clinical Trials for Research in Classical Homeopathy". Her present interests include management of in-patients in homeopathic hospitals, and clinical research in classical homeopathy. She has been in practice for over 20 years and is online at www.homeopathy2health.com for the last 15 years. Presently she is Consulting Homeopathic Physician, with specialization in Cardiology at Holy Family Hospital, Bandra, Mumbai.
Visit Dr. Leela D'Souza at her website : http://www.homeopathy2health.com/member.htm
and contact her at: [email protected]

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