There are many times when a patient’s chief complaint is clear and straightforward. It is easy for the patient to describe such strong and distinct symptoms, which in turn makes it easy for the homeopath to find the symptoms in the repertory, study the case, and prescribe a remedy. Yet sometimes the remedy chosen by the homeopath does not work. In such cases, it is important to consider that a symptom may be representing a larger concept for that patient. When that larger concept is understood by the homeopath, it can be easier to understand the patient’s case and to prescribe effectively.
When I take a case and have elicited a symptom, I ask myself, what is that symptom an example of? Are there other examples of that in the person’s story? This helps both to inform my case-taking and organize the information I get from the patient.
The case below illustrates how seeing the same underlying issue manifested on different systems of a patient will reinforce my understanding of him and improve my ability to prescribe correctly for him.
A man with seasonal allergies
A 30-year-old man came to see me, referred by his wife. He came reluctantly, not believing homeopathy could help the serious seasonal allergies that troubled him about half of each year.
He was well-dressed, neat, and punctual, and appeared to be a straight-talking, earnest young man. He seemed nervous during the interview, perhaps part of an overall anxiety or maybe more the sort of nervousness some people experience when meeting someone for the first time.
I took my time telling him how I enjoyed working with his lovely wife and three wonderful children, and how they seemed to be raising terrific kids. I explained a bit about my approach to medicine and answered his general questions. (I always take time early in the interview to establish rapport with the patient and to set a welcoming and comfortable atmosphere in the consultation room.)
Examples of explosiveness
The hay fever, which bothered him for several months both spring and fall, consisted of tremendous itchiness of the eyes, a runny nose, and frequent bouts of explosive sneezing. The sneezing would come on all of a sudden, was intense and uncontrollable, and left him feeling extremely exhausted. The unpredictability and severity of his hay fever made it difficult for him to drive, to concentrate at work, or to plan outings. He had used all manner of over-the-counter medication with little to no success.
I wondered whether I might find other examples of explosiveness, so I began by asking general questions about his work and family life. He worked in the computer industry and enjoyed the responsibility and respect he earned on the job. He loved his wife and family, but found he had little patience for home life. He was irritable most of the time, easily angered by small things, and would find himself yelling at someone about something almost every day. Being a “neat freak,” as he put it, did not help matters. He knew he was focusing on the wrong things, but he couldn’t help himself. The mean, angry words would escape from his mouth before he had time to think. He would scream and sometimes throw things, frightening the children with his explosiveness. Afterwards he would feel exhausted and wiped out. The way in which he described his anger and irritability was very similar to how he had described his sneezing fits.
We often see symptoms in the physical and emotional spheres that mirror one another, as the Vital Force manifests imbalance in similar ways throughout the system. In this case, both the sneezing and the angry outbursts were examples of explosiveness. I organize my patients’ symptoms accordingly; seeing how symptoms on various systems are similar helps me to receive the case without being overwhelmed by what might otherwise be understood as separate and distinct problems.
Being in control
This patient kept a very strict routine and felt better if he was in control of his own time. To illustrate this point, he reported he’d rather be an hour early than a minute lateâ€”which of course, with a family of five, was a near impossibility. His wife was much more laid-back about most things, which he knew was good in terms of balance and running the household, but at the same time, it drove him crazy.
He tended toward constipation with two to three bowel movements per week, though he did have the urge to move his bowels most days. He desired spicy foods like chicken wings and salsa as well as beer and sweets. He drank some alcohol most days, a beer or two after work, and considerably more on the weekends. He did not see this as a problem, but according to his wife, it was an issue. It took him away from the family and made him inaccessible to her. He would retreat to the basement where he would work alone on his hobbies for long hours. To relax, he enjoyed re-organizing his tools or cleaning his work space.
His sleep was frequently disturbed in the middle of the night with worries about work, finances, and remorse over his outbursts during the day. He was often chilly but perspired profusely, especially when feeling uptight.
A remedy for the whole picture
When thinking about this man, his hay fever, and the way that fit into his overall health, emotionally and physically, I wanted to give a remedy that covered the whole case. Though the hay fever was troubling, we needed a remedy that would also address his issues of irritability, bad temper, self-control, and remorse. One could prescribe a specific hay fever remedy such as Sabadilla or Wyethia (see “The unpredictable world of allergies”, April 2004, for indications) but when the whole person cries out for a remedy and that remedy also covers the physical symptomatology, it is always preferable to give the remedy that covers the whole case.
Looking at his overarching concerns (intense hay fever, irritability and anger, constipation, and insomnia) we recognize many of the key features of the remedy Nux vomica. Furthermore, his attention to detail, yearning for order, and need for control fit well into our understanding of this remedy. His strong and unpredictable temper, his excessive use of alcohol, and his tendency to be chilly further confirmed the prescription.
I prescribed Nux vomica 6C for him to take twice a day for one month. He was a heavy coffee drinker and I was concerned that he might antidote the remedy with all the coffee, yet it was clear he was not quite ready to stop the coffee, hence the low potency, with frequent repetition.
Another dose of “that stuff”
I saw him six months later, not my usual interval for a first follow-up, but some of my patients will only return when they are not doing well. He reported that he’d had no hay fever the previous season, and he could not remember the last time he’d had an angry outburst at home. He was quite pleased, if somewhat incredulous, about the effects of the homeopathic remedy. He had come in because he was beginning to feel a tickle in his throat and wanted to prevent the hay fever from returning. I repeated Nux vomica, this time in a 200C potency, one dose, as he had stopped drinking coffee at some point in the last six months.
One year later, he returned to see me asking if he could have another dose of “that stuff.” He’d been well physically, but was feeling the irritability creeping back. In addition to stopping coffee, he had cut way back on his alcohol consumption over the past year.
Seeing the whole person
I hear of this patient intermittently from his wife, who was likewise pleased with the results. His ability to relax and be more present naturally impacted his whole family. Giving a remedy to help the hay fever, which is what had brought the patient into the clinic, clearly had a more widespread and most welcome influence.
This family has sent me many a hay fever sufferer over the years, some of whom fare as well, others of whom experience slower progress. In my experience, when we can see the hay fever, allergies, eczema, or asthma as part of the whole person, when we understand the symptoms as examples of larger concepts and prescribe accordingly, we can almost always expect better results.*
* For further information on using this approach (Paul Herscu’s “Cycles and Segments”), see www.nesh.com.
Thank you for taking the time to write up this case I have found it very helpful and insightful. I have been looking at a case with similar symptoms and was trying to find the remedy that had the physicals but also encompassed the mental picture of anger and irritability. Never considered nux vom!I will be giving it a try.thanks!