HI Elaine! How are you?
Well, since you ask… I tried tuning my bass today and it’s developed an uncharacteristic buzz….
That is interesting, sort of; I’ve been crazy….
I’m soooooo sorry to hear that! Have you tried Hyoscyamus?
Crazy as in busy; plus, I was teaching this weekend. One of the things that I taught my students was the importance of our observations.
To depict this, I will share a lovely case:
A 26 year old female came in to see me for severe debilitating migraines that she had had for most of her adult life. She was trendily dressed; engaging and smiled frequently.
Wait a minute, what were we supposed to observe here?
That she was trendily dressed, engaging and smiled frequently!
She had 2 very distinct types of headaches:
Trendy, smiling and dressed….
Elaine, don’t write this down! All you have to do is listen. She had tension headaches and debilitating migraines. The tension headaches were felt as a dull ache and would occur daily.
Whoa! Headaches every day? I don’t like the sound of that!
Her migraines would come on around every 10-14 days.
Oh my God! More bad news!
Elaine????? You’re too keyed up! Maybe if you went back to tuning your bass. OK, she had tried all sorts of treatments and nothing helped: homeopathy from numerous homeopaths, chiropractic, physical therapy, acupuncture, different allopathic drugs, OTC herbal formulas. She wore glasses and had her eyes checked regularly. MRI was normal.
Migraines were unilateral, alternating from side to side from one migraine to the next. The pain begins in the occipital region and then extends down to the nape of the neck and up over the vertex to the forehead and then settles in the eyeball causing a pressing pain in her eye. I observed temporary exophthalmos (i.e. her one eye appeared noticeably larger, open wider) on the side that she had the migraine. This would alternate sides in correlation with the laterality of the migraine. Thyroid tests were normal. When the migraine comes on, she has to take pain medication immediately. She needed to lie down in a dark quiet place and be left alone. Headaches are generally worse from long periods of study and if she goes without eating. She has an aura before the migraine comes on–dizziness and nausea and the nausea increases as the migraine sets in. It has resulted in vomiting on occasion, but was ameliorated by lying down in a dark room. She needed to loosen her bra during these episodes. She always wears sunglasses when she is outside.
She was constipated–cigarettes would help (she was a social smoker) and could go a day or two without passing stool. She doesn’t drink alcohol, because she doesn’t like to be out of control. She prefers to be the one to drive when going places. She is not too thirsty, drinks water (room temperature) and coffee. I observed mild halitosis.
She has had the same boyfriend since high school. She complained that she has no sex drive and that she has no energy. (At this point she cries.) She apologizes for crying. She has a good relationship with her younger sister, but complains that her parents show favoritism toward her–parents bought her sister a new car and she doesn’t think it’s fair. When she is upset, she tends to hold things in.
She describes herself as caring and likes to help others. She is a picky eater, but loves exotic food, seafood and spicy foods. In general she likes things that are unusual. She has strong likes and dislikes, she hates cats. She is not very athletic and doesn’t like to exercise much–she doesn’t like to perspire.
What is to be cured:
Lack of libido
Emotionally closed down +- low grade depression
Lack of energy
Lack of libido
Lack of energy
Lack of libido
Mental & Emotional
Jealous over parent’s favoritism towards sister-it’s unfair
Low grade depression
Holds emotions inside (and stool)
Modalities: of migraine (< = worse, > = better)
< long periods of study; missing meals
> lying down in a dark room alone
But these are ALL generic/classic migraine symptoms. What is unique, what is special, what is Strange, Rare & Peculiar?
Eye wider on the side of the headache.
*This was my observation, the patient hadn’t noticed this. This illustrates the value of our observations as a homeopath
Now how do we repertorize this observation?
I looked in Murphy: Eyes; EXOPHTHALMUS, (20) : aml-n., ars., aur., bad., bar-c., bell., cact., calc., con., crot-h., dig., Ferrum, Ferr-i., ign., Iodium, lycps., nat-m., phos., Secale, spong.
But none of these remedies seemed to fit the rest of the case, except Nat Mur which had already been given.
I looked in Complete:
Eyes; PROTRUSION; general (148) : acet-ac., acon., adren., aeth., agn., aloe, aml-n., amyg-am., ang., anh., antipyrin., apisin., aq-mar., aran-ix., arn., ars., ars-i., ars-s-f., atra-r., aur., aur-ar., aur-i., aur-s., bad., bar-c., bar-i., bar-s., Belladonna, bor., brass-o., brom., bufo, cact., calc., calc-f., calc-i., calc-p., camph., cann-i., canth., caps., cedr., cham., chin., chin-ar., chlor., chr-s., cic., cimic., clem., cocc., colch., coloc., Com., con., crot-h., cupr., cyt-l., dig., dor., dros., dubin., dulc., echi., ephe., ferr., ferr-ar., Ferr-i., ferr-p., ferr-s., fl-ac., flor-p., fuc., glon., graph., Guai., gymn., hed., helo., hep., hydr-ac., hyos., ign., iod., jab., kali-ar., kali-c., kali-chl., kali-i., kali-n., kreos., lac-ac., lac-c., lach., lachn., lam., laur., lyc., lycps., m-arct., mag-c., mag-f., mag-s., merc., merc-c., morph., mosch., Natrum mur., nat-p., nat-s., nux-v., oena., op., par., phos., plat., plb., puls., rhus-t., sang., sant., sapo., saroth., scut., sec., sel., spig., spig-m., spong., squil., stann., staph., stel., Stramonium, stroph., stry., sul-ac., sul-i., sulph., tab., thal., thala., thuj., thyr., thyreotr., tub., verat., vip.
Eyes; PROTRUSION; general; headache, with (2) : cimic., lachn. (Cimicifuga had already been given)
Often our observations are difficult to repertorize, we need to be creative.
I finally looked in Sensations as if: A repertory of subjective symptoms by Roberts
I found: “Sensation as if eye pulled wide open with a string“.
Only 2 remedies are listed, one is Onosmodium
ONOSMODIUM VIRGINIANUM – Onos. False Gromwell. Gravel Weed.
Indications taken from Boericke and Vermeulen
A remedy for migraine..
Marked association of head and eye symptoms, with muscular tiredness and weariness.
It produces diminution of sexual desire in both sexes; hence its homoeopathicity in sexual neurasthenia.
General prostration. Acts as if born tired.
Eyes feel as if they were very wide open. Pain in orbit with a feeling of expansion. Dull heavy pain in the eye – balls.
Acts on the MUSCLES and nerves of the eyes, occiput and FEMALE PELVIC ORGANS
Vertigo, with headache
Migraine Occipito – frontal pain, in morning on awaking and dull heavy pain pressing upward in occiput with dizziness Marked association of head and eye symptoms, with muscular tiredness and weariness
Eye – symptoms are characteristics
Hyperaemia of the optic disc with enlargement of the retinal vessels.
Pain in eye – balls
Sexual desire in females completely lost [Btt.]
Onosmodium has been well-known as a remedy for muscular asthenopia, and headache or migraine with eyestrain.
Onosmodium is also an important remedy for sexual neurasthenia, a broken-down state.
AGGRAVATION: From motion; from jar; from sexual excesses; from humid air; and from tight clothing.
AMELIORATION: From rest; when lying down on back; after sleep; and after eating.
RELATIONSHIP – COMPARE: Cimic., Gelsemium, Lil – T., Nat – Mur., Rhus – T., Ruta.
DOSAGE: 30th potency.
After giving her the remedy, her migraines completely went away. She still had the milder tension headaches which became less frequent with treatment. Her bowels became regular and she appeared lighter, happier and freer in her expression. Her overall energy and feeling of well being had improved. She had a period of anger with her boyfriend (which she expressed). After that their relationship improved. 4 Years later she continues to do well.
Now, let me make an observation! You’d have to be a genius to solve this case!
To get to Onosmodium, you have to ignore the most obvious symptom in the case, which is that the migraines alternate sides! And, oddly enough, she also hates cats–Lac Caninum (dog’s milk) is the obvious choice; so, I have to ask, did anyone give her that? Also, is there any way to repertorize: headache begins in the occiput, goes to the nape of the neck, goes back up the head to the forehead and settles in the eye? I feel very discouraged because we all know if we follow the path of the headache we can arrive at Silica and Gelsemium, etc., but, apparently, here we were supposed to just ignore that…how do we know what we’re supposed to ignore? Look at all the other peculiars in the case: tobacco ameliorates! Boy, there’s a symptom for you! Here’s another one: photophobia, yet opening the eye ameliorates–there’s a paradox for you! (Ignatia?) Headache: periodically, every 14 days. I’m afraid this case would have had me over a barrel. Well, Gabrielle, you win seconds at the dessert counter! Where does constitutional prescribing fit into this case? There are those who would say that if you prescribe on the local symptom, you suppress the case. I’m going to go back to tuning my bass now.
Very good points, Elaine!!! And YES, Lac-can was given!
The main reason I presented this case was to emphasize the importance of our observations.
This was one of those cases that had done the rounds.
Some of you reading this may feel discouraged. Remember that every one of us has had a patient where we have tried everything, taken a perfect case, given a remedy we were sure would help and nothing helped. Feel encouraged that with a little bit of creativity, and flexibility, often a remedy can still be found.
Constipation ameliorated by tobacco is fairly common, and this is one of the common problems faced by people trying to quit smoking.
When we look at the rubric “photophobia, yet opening the eye ameliorates”, in the rubric alone, it tells us a lot about the paradoxical nature of Ignatia. However in our case, the deeper meaning and repercussions are in fact very different. Here the SRP is that even though her eyes are sensitive to light, she is better for opening them but in our case the fact that her eyes are sensitive to light is very generic to migraine sufferers and therefore not that useful. The unusual feature in this case is that:
Not both eyes are open wider-it is only on the one eye that is fixed wide open and ONLY DURING the headache and ONLY ON THE SIDE of the headache. This is a perfect example of how easy it is to fall into the trap of using rubrics, which appear similar, but have very different meaning for the remedy to that of our patient.
If you look at the whole picture of Onosmodium, it fits her entire case on every level: The constipation, her lack of libido, her depression and fatigue. I believe that this is in fact her constitutional remedy. We can verify this by her reaction to the remedy: she improved on every level: physically, mentally and emotionally.
Aha! Then, forget I said anything.
While Onosmodium is a fairly unknown remedy by homeopaths today, it was widely used by and better known by homeopaths in the past. One of the rants that I have is that we are so busy searching for and proving new remedies (sometimes not very well), that our vast data of materia medica becomes diluted and we forget about our lesser known, yet extremely well proven remedies. Many of the remedies that you thought of, you thought of because you already know the remedy. If you look through Boericke, you will find numerous remedies that you may not even have heard of, yet served homeopaths excellently for hundreds of years.
I know I’m going off on a tangent, but I would also like to make a comment about provings, if I may. I feel so very strongly about the importance of us keeping provings scientific and pure. While I do love the idea and concept behind dream provings, thought provings and some of the newer, more alternative provings, I think that it is vitally important to record these symptoms in separate materia medica and separate repertories. Many of these provings are based on interpretations, doctrine of signatures, etc. While this information is useful, our provings are the one area that we need to keep purely scientific in order for homeopathy to survive. As a women changes over her 30 day monthly cycle (and men have cycles too) a log should be kept of symptoms experienced for at least 30 days before the proving begins, and a clear distinction should be made between symptoms of the prover and symptoms of the remedy. No symptom of the prover should be recorded in the proving. In addition, symptoms that come out in a proving should be graded according to intensity as well as the number of subjects that experienced this symptom. Such distinctions should be made in our materia medicas and repertories. There should be a greater level of standardization in choosing the subjects in a proving. They should only be chosen if they are in good health both physically, mentally and emotionally. All provings should go through an international standardization board before they are allowed to be published in our literature. Although this seems like a lot of extra work, it will save us all so much time and work as homeopaths and I believe significantly improve the success of our treatments.
I just checked the hpathy Rule Book, and then I ran it past an international commission, and it turns out, you’re not allowed to go off on a tangent. By the way, here’s an idea! Let’s talk about the double-blind study you conducted on Exam Anxiety!
OK. The study was a double blind clinical trial, comparing a placebo control with an experimental group. Thirty-two students experiencing difficulty with thought interference, nervousness and anxiety were analyzed. The subjects were divided into an experimental group and a non-experimental group, ensuring that each group had an equal representation of subjects according to age, sex, course of study, year of study and previous academic achievement. Group 1 was given homeopathically medicated powders; Group 2 was given un-medicated powders (placebo i.e. lactose granules)
1) Subjects were selected on a volunteer basis in response to advertisements placed at Witwatersrand Technikon. (The University where I studied, now called University of Johannesburg). These advertisements were aimed at students who get anxious before exams and have difficulty focusing their thoughts.
2) Subjects must have been tertiary level students between the ages of 18 and 30 years.
3) The subjects must not have had any underlying illnesses e.g. epilepsy, stroke, attention deficit disorder (ADD), thyroid disorders. (While this was a prerequisite, after the study had ended, many of the subjects came to me for constitutional homeopatic treatment and many of them had undiagnosed ADD, bipolar disorder, and even schizophrenia)
4) The TAP was administered and marked by a registered psychologist.
5) Medications were prepared and labeled by a registered pharmacist, who recorded the nature of the powders. Owing to the double-blind nature of the study, neither researcher nor subject was aware of the nature of the medication.
6) Medication was prepared homoeopathically and to the standards laid down in the homoeopathic pharmacopoeias.
7) During testing, all variables were kept constant to all subjects . Subjects were all tested under the same conditions, thus eliminating extraneous variables that may have had an effect on the study.
8) All data was recorded and the results statistically analyzed. Means and standard deviations of the 2 groups was determined and compared using correlational tests to determine the true significance of the results.
 Subjects: The subjects are all Technikon students and have therefore achieved a matric exemption.
Why just the three remedies: kali p., arg-n. and gels., what led to the choice of these three? How did you decide who got what? Did you personally do the testing all by yourself? Did these students, all 32, profess to being nervous or blanking out during exams?
We had a student clinic on campus, and even before the study, I had been treating a great deal of students suffering from anxiety and difficulty retaining information.
I had a standard protocol for all subjects in the experimental group. I didn’t want to rely on the accuracy of my assessment. Please see the protocol below. I conducted this study as a 6th year Homeopathy student and with very little clinical experience. Most of the research in homeopathy in South Africa is done by newly graduated homeopaths. While today I would have done this study quite differently, it nevertheless obtained favorable results and valuable information for students. Because many of the subjects noticed an improvement in just one week, most of the subjects came to see me after the study for constitutional treatment. Interestingly enough, very few of them were given the remedies used in the study.
Because the testing period took place over just one week, and because it was during exam time and the students were all in an acute state of stress, I decided on using 200c potencies. Note that while I had given repeated doses of 200c, NO AGGRAVATIONS were noted. Actually I encountered very few aggravations while practicing in South Africa. However when I moved to the United States, I had to completely change my style of treatment, significantly reduce my dosages and repetitions and still encountered far more aggravations. It may be due to the diet and the level of suppression in Americans, or it may be due to the fact that in South Africa, it is common practice to alternate the constitutional remedy with a miasmatic nosode. I was reading Ramakrishna’s book and he alternates remedies in this way and attributes his infrequent aggravations due to this method.
INTERVENTION (HOMOEOPATHIC MEDICINES)
Each subject was supplied with a box containing 8 powder sachets of medication. The powders were labeled 1-8 according to the prescribed dosage sequence. The advantage of using this method enabled alternation of the remedies while still maintaining patient compliance and avoiding confusion. Powders were taken orally twice a day.
DIRECTIONS FOR DOSAGE AND FREQUENCY
|Day||Time||Testing||Powder number||Homeopathic Medicines||Homeopathic dilution||Un-medicated powders|
|Monday||Morning||IQ & TAP 1* (Pre-test)|
|Evening||1||Kalium Phosphoricum||200 CH||PLACEBO|
|Tuesday||Morning||2||Kalium Phosphoricum||200 CH||PLACEBO|
|Evening||3||Argentum Nitricum||200 CH||PLACEBO|
|Wednesday||Morning||4||Kalium Phosphoricum||200 CH||PLACEBO|
|Evening||5||Kalium Phosphoricum||200 CH||PLACEBO|
|Thursday||Morning||6||Kalium Phosphoricum||200 CH||PLACEBO|
|Evening||7||Argentum Nitricum||200 CH||PLACEBO|
|Friday||Morning||8||Gelsemium Sempervirens||200 CH||PLACEBO|
|Afternoon||IQ & TAP 2 (Post-test)|
TAP: Test Anxiety Profile
The above sequence and choice of potency has been carefully selected according to the therapeutic action and length of action of each remedy, and has been found effective in clinical experience. The control group (Group 2) received powders containing placebo (lactose), identical in appearance and taste.
§ The group taking homeopathy had a 15.42% decrease in anxiety, whereas the placebo group showed an increase anxiety.
§ Statistically, the biggest difference was in the “Math test” section where the homeopathic group showed a 22.59% decrease in anxiety, while the placebo group had an increase in anxiety. (P=0.0384).
Thought interference (Difficulty concentrating and remembering information)
§ The homeopathic group had an 11.88% decrease difficulty concentrating and remembering compared with a 8.50 % decrease in the placebo group.
§ The biggest difference statistically was in the “Giving a talk in front of a class” section where the homeopathic group had an 11.36% improvement, whereas the placebo group had a -1.40% worsening of their symptoms (P=0.00623).
From the results, it was apparent that homoeopathic treatment is effective in reducing thought interference and feelings of anxiety in tertiary level students under examination conditions.
Kalium phosphoricum, Argentum nitricum and Gelsemium sempervirens were all given in a 200c potency
There are 351 homeopathic medicines used to treat anxiety and 255 homeopathic medicines used to treat memory and concentration difficulties.
However this study did not attempt to investigate any of the other remedies. The testing period took place over just one week.
For more details on this study and information on Homeopathic treatment for Attention Deficit Disorder, please visit my website: www.discoverhomeopathy.com and click on Conditions (and then on ADD) and on Articles.
While 15.42% improvement in the homeopathy group (while the control group got worse!) doesn’t seem that significant, bear in mind that this change occurred in just one week and was significantly noticeable to the students. Consider too that by the end of the examination week, students are generally more stressed out than in the beginning of the week, as indicated by the results in the control group.
In my protocol, I gave Gelsemium at the very end. Gelsemium is often a more degraded state than the Argentum state. Kent noted that many Argentums fall into a Gelsemium state as their nervous systems become more and more depleted and you can see this by comparing the pace of the 2 remedies: While in Argentum, the pace is very lively, open, talkative, active, energetic (actually too much energy), the Gelsemium state has sleepiness, trembling, weakness, loses all thought or memory, complete blankness, eyelids become heavy, going into a catatonic stupor and so on.
You’re right, there’s no comparison between the two! Well, the people who are always saying that there are no double-blind studies to prove that homeopathy works, I’d love to hear what they have to say about this!
How did things go at the homeless shelter you told us about last time you were here? Were you asked to leave?
Short answer? Yes. Unfortunately the previous location did not work out, however life always has a way of directing us to where we need to be, as two incredibly exciting possibilities that have just opened up. One of which will involve helping victims of Katrina who have relocated to San Diego. Our ideal is to have a “Homeopathy Without Borders” set up, right here in the US, addressing local issues. I will keep you posted.
Please do! What was the other one?
More great news. I was approached by two OB GYN’s who have asked me to join their practice starting in November. So in addition to where I am now, I will be expanding to a more traditional medical setting. Should be interesting.
Well, it’s not a exactly a homeless shelter, but….
Oh, Elaine, I forgot to add.
We are currently accepting applications for regional co-coordinators for World Homeopathic Awareness Week 2006. Visit www.whomeopathy.org for details about World Homeopathic Awareness Week.
Currently accepting applications for Regional World Homeopathic Coordinators for 2006 !!!!!
To apply write to Dr. Traub at [email protected]
Gabrielle, you’ve got a lot to keep us abreast of–the Hurricane victims you’re treating in San Diego, the OB/GYN practice, the never-ending search for a homeless shelter…I hope you’ll be back before long! We’ve loved having you!
Stop the presses! News Flash! This just in:
Great news, I am having a meeting for the San Diego Rescue Mission on Monday-It looks like our homeless clinic will have a home after all-I will keep you updated. We may start a flu clinic there-more details to come….
Chair: World Homeopathic Awareness Committee
Medical Wellness Kliniek
3268 Governor Drive
San Diego, CA 92122
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Email: [email protected]