A knock on the door
It is Christmas Eve in a cold climate. Snow lies heavily over the ground, ice hangs from the windows, and the crisp sheen on the phone wire stretching over the apartment block tells us it is unlikely we will have any reception. Mobiles are still rarities. Suddenly there is a soft knock on the door. Standing there is a woman, a student in our homoeopathy course. Tightly holding her hand is her son, 10-year-old Vlado. His cheeks look flushed rose red with fever over their natural translucence; his big dark eyes loom largely under his long fine eyelashes. The concrete corridor outside is cold and dark. Come in, I hasten, come thru; we have heating, it’s warm here. They emerge into our living room, and on invitation the boy sits deeply into our cavernous settee still clutching his mother’s hand. A rather weak cough punctuates his rather shallow breathing.
His mother speaks. ‘We’ve come from the hospital, they gave him a chest X-ray, pneumonia.” She fumbles in a large bag clutched to her knees. In this place it’s bad luck to place a handbag upon the floor. She withdraws the envelope, and opening it I peruse the X-ray. This time I have to agree, it looks to be pneumonia. So often here we see over- diagnosis but not this time. The boy coughs again, a weak, trembling yet rattling sound.
“They would have admitted him,” says the mother, “but he begged not to be left there and it’s Christmas, there will be hardly any care. They gave a note to get some antibiotics but I don’t want to. And oddly, he hasn’t got fever now.” She smiles at me hopefully. Vlado is a boy I know a little. When I have seen him before he has seemed quite mature for his age, independent and confident. Now he looks shrunken by his mother’s side. Still holding her hand and anxious seeming; ‘Mum” he suddenly says” Are you sure the car is all right where you parked it? Have you got the keys safe?” he surprisingly queries.
Indications for Phosphorus
Treating pneumonia is not something we do every day outside of a hospital setting. But here the remedy looks clear and I know I have it. “Five doses of Phos 200, every four hours or as the symptoms indicate, you know how to do it.” After all she is a good student, a good observer. “Go home now, bed, warmth, plenty of liquids; phone me tomorrow if the lines aren’t down. If they are I’ll come round.” I know where they live, in a neighbouring quarter. I can walk it if the snow lets up a bit.
Phos? Yes . What do we observe?
Clinging – takes hand of mother (in an acute what matters is the change of behaviour from the normal)
Face, redness cheeks, without fever
Anxiety for others.
Christmas Day and Boxing Day (days 2 and 3)
The next day arrives, bright and sunny; it’s not snowing now but the phone line is dead. I’m glad to dress brightly and walk round to my patient’s home. I’m relieved to find they too have heating. Vlado is in bed. “The case has changed,” says mother. “All night he wanted me to stay in the room and sleep near him. And he coughed a lot at first. But then the cough seemed to pass but he complained his chest felt tight. He said he was better alone, sent me away.” She looks upset and, now, worried. I go in. Vlado is lying, on his right side with his face to the wall. “Do not bother me,” he says. “I want to be home and left alone.” He coughs and it sounds stronger but dry and I notice that he holds his chest.
This is not good progress, I think. But still we have a clear remedy.
Disturbed, averse to be
Chest pain, cough
Cough, dry painful
Holding chest amel
We have moved to Bryonia. We used to learn that Bryonia could alternate with Rhus tox. I have observed that, while that may be true in, for instance, flu, in chest infections it is just as likely to alternate with Phosphorus And indeed the next day, with the phone lines back at last as the sun dries out the wires, the mother reports a return to the Phos state and that remedy is duly given.
By the fourth day, Vlado is up and about, but he still looks translucent and his eyes still stagger me by their size and darkness under those long, long lashes. He is weak and has a hollow cheated look about him, which I did not remember noticing when I had seen him before his illness. Vlado and his mum are back in my place, at his request, for he tells me he was tired of being cooped up at home. He wanted to get out, didn’t like being in the warm flat, prefers the cool snowy air. I listen to his chest and I can still hear the mucous rattling, especially at the apex of his lungs. He is now coughing up mucous, lots of it indeed – which is good. But we are not home and dry yet, despite Vlado seeming in many ways to be back to his normal self emotionally, neither holding his mum’s hand nor seeking to be alone.
I decide the time has come to go a little deeper with the case. As I suspected, the family history yields several cases of TB and when a baby Vlado himself had reacted positively to the Heaf test (a diagnostic skin test to determine if the patient has been exposed to tuberculosis). In this country there are still quite a few live TB cases about and BCG vaccination is compulsory at a few days old. I decide it is time for a miasmatic treatment: Tuberculinum 200c, single dose.
But the next day the mother phones to say she is a bit concerned. Vlado has become irritable and upset. He keeps insisting the flat is too warm, though he has no fever. He is coughing still and although the cough is nearly gone and she cannot hear anything in his chest, he is complaining of it burning, and of having pains there extending through to his back when he coughs. She says he is hanging around the apartment, sulking, peevish, complaining that he has not had the right treatment, Not at all like his usual sensible philosophical self, she complains.
So what to do now? A wise head says that tuberculinum is a deep and long acting remedy. We should wait. But I wonder. This is an acute. May be this is not the best time to do too much deep miasmatic work. One of those wise sayings we were taught years ago at college pops into the mind: Sulphur is a good remedy to open a chronic case, and to close an acute one. That’s what we need now, closure, for this usually philosophical but now peevish boy. One dose of sulphur is prescribed.
A New Year hospital appointment
Two more days pass. The holiday week is over and it is time for the mother to present her son at the hospital for the recall appointment they had requested. There the boy’s chest is X-rayed again and the doctor looks in some surprise. But the pneumonia is completely resolved. She says, “I have never seen such a complete clearing in one week. What antibiotics did you use?”
“Oh, I can’t remember” says the mother, quietly.