Many times there are instances in the clinic where we have cases with peculiar symptoms which we tend to overlook and those symptoms are mentioned at various places in our keynotes, red line symptoms and in materia medica. On careful study we can highlight those symptoms. I’m presenting a few snapshot prescriptions where such peculiarities of symptoms helped me to arrive at a remedy with quick results!
Let’s start by understanding the case:
Case 1) A few months back I saw a patient having chronic migraine, mainly left sided and mainly over the orbital region. She had already consulted various physicians but with very little benefit. I asked her to also relax, and when having the acute episode, to do pranayama (breathing exercise) to which she said this is not at all possible. She said “When I close my eyes and try to meditate during exercise my symptoms gets more intense, especially at night. The characteristic symptom was more aggravated by pranayam (breathing exercise) and aggravated when at night. Usually, kind of deep thoughts aggravates him. No other symptoms were more clear, except for repeated cramps in muscles which he gets often. His calcium and vitamin D levels were normal and there was no other pathology.
Now, which remedy has headache < by meditating? If you know this you will crack many cases of migraines and other types of headaches. On looking for it I found a few remedies which cover this symptom: china, cocculus, Limulus.
I took it as aggravating from meditating (ref: Boericke MM) and < left sided, settles in eye. Also, cramps in legs on and off.
The remedy which has these symptoms is “Limulus” – Horseshoe Crab.
Sometimes we overlook small remedies which may have very peculiar symptoms. I studied this remedy further and found the properties of this animal. The blood of limulus is blue in color as it contains copper, which is often indicative of spasms.
We know that cramps and spasms are also a keynote of copper which is the active ingredient in this remedy!
One more close rubric could be: Head pain, attention from too eager- anac., ign,. nux-v., sabad. And in Clarke’s MM he mentions this in relation to china and cocculus. But the idea of prescribing in this way needed three confirmatory symptoms and the remedy which covers all three. So it narrowed down to Limulus.
I found that the blue blood of Limulus is not just ordinary fluid. It evolved in such a way as to fight off infections which it has to live with in marine life. The horseshoe crab has a compound in its blood — LAL, or Limulus Amebocyte Lysate — which immediately binds and clots around fungi, viruses, and bacterial endotoxins. This blood is now used by all labs and as a standard for screening the blood endotoxin levels. The price of one quart of horseshoe crab blood has a price tag of around 15,000!! Now that’s the reason I feel it is known as King Crab!
Rx: Limulus 30 BD for a week helped her to get rid of her aches and migraine in a short span.
Sometimes these small unnoticed remedies are gems in cracking some complicated cases.
Finding Peculiar symptoms and making prescriptions
Stuart Close, in his The Genius of Homeopathy, gives the origin of the creation of the “keynote system.” It was taught and practiced by Dr. Henry N. Guernsey in the last half of the 19th Century.
The critical task during the case analysis is aimed towards filtering out the peculiar from the common diagnostic symptoms until we can find the leading keynotes. These keynotes generally pointed to one of the well indicated remedies in our Materia Medica. It is crucial that we know the remedies really well, because prescriptions have to be made on the spot. The “Bold type” symptoms from Allen’s Key notes, Bhanja’s Homeopathic Prescriber, Boericke and Phatak’s Materia Medica and Nash’s trios are the main resources.
The key to good prescriptions was also about good observation and objective symptoms. What was also interesting was that some of the most peculiar concomitants were elicited during the general examination as objective symptoms.
Eg: Cracks all across the tongue in every direction confirmed Nitric acid.
Hair on the middle phalanges ( hair in abnormal places) is the keynote for Thuja. The exact purple shade of the wound pointed to a Lachesis. Consolidation at the apex of the left lung in an Xray pointed to Sulphur. Linear complaints in eruptions point towards all-c, syph, caust, sep.
Case 2) Justicia Adhatoda
This was a case of a child with cough and coryza, with terrible itching in eyes. The child was restless and had profuse fluent coryza and lachrymation, loss of smell and taste for food. Feverish feeling with difficulty in breathing. The cough was paroxysmal (first observation), tightness was the sensation he felt. Had to hold neck while coughing. Based on this I had given him Allium cepa but it didn’t work, Lachrymation was increased so I prescribed Euphrasia, but it also failed to work!
This time I thought to prescribe an Indian remedy – Justicia adhatoda 30 BD and to my wonderment I found in Boericke’s material medica – last line of that drug “Seems to come between Cepa and Euphrasia, which compare….” and this remedy helped him in just few hours.
Case 3) Phytolacca Decandra
A case of pain in foot and difficulty in walking barefoot. A homeopath had referred this case to me, which was treated earlier with Bryonia, Rhus tox, Arania etc. but nothing had helped her for a long time. Along with this she had follicular tonsillitis due to cold drinks along with aphonia. This was enough data to arrive at prescription a prescription of Phytolacca D 30 BD for 1 week. In a month’s time she was remarkably better!
Boericke mentions : this is a glandular remedy with effects on fibrous and osseous tissues, fascie, muscle sheath, scar tissue. Syphilitic remedy.
Allen writes in his book on keynotes: Rheumatic diathesis, occupies a position between Bryonia and Rhus tox; cures when these fail though apparently well indicated.
Exploring rubrics from repertory in a clinical sitting
Short excerpt from a case: I had a case of an old woman with the chief complaints of forgetfulness and depression. She tends to forget while speaking. Now in such a case while looking for rubrics we check mainly at two places:
1) Mind: fortgetful 2) Mind: memory- weakness
While working out with the case, I came across some interesting rubrics below:
1) FORGETFUL, words, of, while speaking:
They are having a conversation and do not find the right word. Eg: “Doctor Dhruv, you know what, last night I forgot to take that….. what? That round thing what we called na… what? I’m not getting that word but you give that every time…”
I said did you mean big sized pills? Medicines?…. “Yes”
Every paragraph she needs our input to recollect.
2) sub rubric: Forgetful, something, feels constantly as if he had: Constant feeling that he is forgetting every now and then.
CAUSTICUM: Here the reason is a type of paralysis of his memory.
3) Another interesting sub-rubric: FORGOTTEN things, come to mind in sleep:
SELENIUM: He is forgetful the whole day through. When he sleeps peacefully, he remembers everything, for example in a dream. It is also a symptom of sclerosis of the brain.
4) Forgetful, purchase; goes off and leaves the: forgets to take along the bag of shopping which she purchased or left out while travelling in busses and trains.
We came across this common saying from patients.
Thus, exploring more rubrics and understanding how it would be expressed in patients helps us to be more exact during our case taking and acute prescriptions.
T conclude, it’s not just a random collection of symptoms we select but one which is peculiar and characteristic of the remedy and that same if found in patient, then it creates wonderful results. We strive to exploring our materia medica and repertory and get exactness of symptoms.