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An Understanding of Compound Remedies: Calc-Sil, Nat-Ars, Kali-Ars

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Dr. Rajan Sankaran discusses the use of compound remedies, including how they should be chosen, and gives case examples.

As Homeopaths we constantly seek to expand our Materia medica knowledge in order to add more tools to our armamentarium. Kent has done the same and has added some new remedies like Culex musca, and contributed vastly to the idea of compound remedies, such as Mag phos, Calc sil, and Kali sil. He was toying with the hypothesis that perhaps these remedies contained features of their constituent elements. Kent then chose all the rubrics from the repertory that had both the elements of the particular compound and listed these rubrics as an experimental materia media of the compound itself.

He then used these remedies clinically and discovered some unique symptoms that were not present in both the elements of the compound. For example, the symptom of “talks to dead relatives”, Kent listed under Calc sil, but it was not contained in Calcarea or Silica alone.

In my own practice I have found that these compounds are very useful and that they represent the interaction between two separate elements. For example, if the main theme of Calc is financial insecurity, and the theme of Sil is the need to live up to a certain image or expectation, then the clinical indication of Calc sil would be a feeling of financial insecurity if one did not live up to a certain expectation. To take a real-life example, we can think of when one goes for a job interview and they feel that if they do not meet the expectations of the interviewer, they would not get the job and there would be financial insecurity.

As Kent found, I confirmed that usually these compound remedies do contain features of both constituent elements and unique features also, which often come from clinical experience.

My only addition to this is that in order to prescribe such a remedy, it is not sufficient to have some symptoms of Calcarea and some symptoms of Silica. You must understand it to be the core experience in every sphere of the patient, which may be found in his nature, fears, interests, dreams, childhood, etc. The core feature of any of these areas in the patient’s life should be the cross point or interaction between the theme of Calcarea and Silica.

To demonstrate this concept, below we will study the following compound remedies:

  1. Calcarea silicata (Calc-sil)
  2. Natrum ars (Nat-ars)
  3. Kalium ars (Kali-ars)

Calcarea silicata [Calc-sil.]

Calcarea silicata is a salt and represents a combination of feelings of both Calcarea and Silicea. Like Calcarea, the person feels insecure, with the need for protection and like Silicea, he feels the need to maintain a particular standard. Hence the feeling of Calcarea silicata is: “I need to keep up to a particular standard to get the security and protection I need”.

In my experience, the situation of Calcarea silicata is that of teenagers belonging to the middle class of Indian society, especially boys who feel that a lot of expectations rests on them. They feel the need to come up to a certain standard to get the approval of their parents (whose security they seek).

The Calcarea silicata patient has a fear of poverty and so he has to be careful about spending money. Being poor puts him at a disadvantage. Therefore he becomes yielding. He cannot stand up or assert himself, he would rather escape. He is not as obstinate as Silicea.

The need to maintain a certain standard gives Calcarea silicata its sensitivity to reprimands. Here it compares with Staphysagria in that both drugs have a high sensitivity. This sensitivity to reprimands keeps him from confrontation and getting fired and hence maintains the standard that his superior sets for him. He also becomes timid, bashful, yielding, irresolute, hesitant, since this will help him. Also, he has a lot of anticipatory anxiety before exams, interviews, meeting people or before beginning a new job. This is a situation where support is available (unlike Psorinum, who has fear of poverty but no support, so he becomes despairing). So he turns to people for support, trusts people, gets psychotherapy (“Desires to be magnetized”: Calcarea, Silicea).

In addition to all this, Calcarea silicata is very anxious about health. Teenage boys spend hours waiting at the clinic worrying about cough, cold or fear of heart disease. Its advantage is that it gives them an excuse for non-achievement and dependence. This is where Calcarea silicata differs from Silicea and Staphysagria. When he comes to the doctor the patient has the fear of a serious disease, but subconsciously he uses this fear to do nothing. If he is told he has no problem he can get irritated (“consolation aggravates”). He wants support but doesn’t want to be told he has no problem. This sounds contradictory.

It is this great dependency financially and socially in Calcarea silicata that compares it with Baryta carbonica. When the person who supports him dies, Calcarea silicata is devastated and may go into a shocked state – automatic conduct. He may either sit still and do nothing or, as a survival mechanism, he may imagine that this person is not dead and may talk to him. For example when the husband expires, the wife who was emotionally and financially dependent on him imagines that he is in the next room.

Baryta carbonica and Calcarea silicata both come from a disabled state. Calcarea silicata is disabled in a sense that he is not able to achieve what his parents want him to. The really disabled man like Baryta carbonica does not need an excuse for not achieving but Calcarea silicata consciously looks for such an excuse and this very fact shows that he knows he has to achieve. Calcarea silicata consciously feels the need to achieve which Baryta carbonica does not feel. What is expected of him is usually money. Since he finds these goals too high for him to achieve, he has to remain financially dependent and hence he becomes mild and yielding. The reason why most Calcarea silicata people are non-achievers is that they come from demanding yet supportive families.

In Staphysagria, Silicea and Lycopodium the survival depends on achieving, whereas Calcarea silicata has given up trying to achieve and his survival depends on finding excuses not to achieve. Still, they are not really failures. They do achieve but much less than what was expected from them.

This feature of struggling for a while and then giving up is characteristic of the ringworm miasm, to which the remedy belongs.

Calcarea silicata has dreams of anxiety, insecurity. He can have pleasant dreams of being with his family or talking to dead relatives.

Physical symptoms:

  • Physically they are lean, chilly patients
  • Sweaty palms and soles, especially cold, sweaty finger tips
  • Blue line on gums
  • Suppurative problems like sinusitis, bronchitis with offensive discharge

Case Example

Dr. (Miss) B.K, a 24 year old homoeopathic physician came with the c/o of Asthma since age 7 years during exams, relieved by sitting bent forward. She feels very weak during the attack. She has always been very tense before exams and important engagements. Trembling when nervous, especially before viva voce. She has a marked fear of dogs and of dark. When she goes out, has a constant feeling that people are looking at her. She cannot eat at parties on account of this feeling. Describing her nature, she wrote in the case record that she is proud and leads the life of an obedient, sincere, hardworking person. She is very shy, very serious, lacks confidence and is very much concerned as to what others think of her. She has a marked fear of failure. She is obstinate. Fastidious – much affected by disorder, “simple” and feels she cannot adjust in a large family after marriage. Her prospective in-laws want to start a nursing home for her. “They have high expectations of me and I doubt my capability”. She is irritable before menses.

Dreams: (1) Missing the train and therefore late for exams (2) I don’t see the exam time table properly and therefore prepare for the wrong subject.

She craves chocolates and ice-cream. Profuse perspiration on the back, forehead and palms, staining yellow and sometimes indelible. Menses: stains difficult to wash off. Occasionally breast tenderness before menses. On examination nails are ribbed vertically and have white spots on them. The soles of the foot are cracked.

Case Analysis

The case has strong psoric and sycotic components thus falling into the ringworm miasm. She has sycotic features on the one hand, fastidious, indelible stains left by discharges, while on the other, the fearful aspect seeking security and protection. She tries to live up to the expectations at times and hence gets highly nervous, but at other times she just feels she cannot do it. This feature of struggling for a while and then giving up is characteristic of the ringworm miasm. As on the one hand we have features of performance especially with respect to exams and on the other there is need for security and protection, I gave her Calcarea silicata 10 M/1 and there was a remarkable change in the mental outlook and complete disappearance of her asthma.

Calc-Sil has “Anxiety about health” and “utterly ambitionless” on one side while on the other, it also has “hurried”, impatient and “anticipatory anxiety”. The patient feels incapable of performing and gives poor health as an excuse for not being able to perform but at other times he somehow tries to live up to the expectations.

Natrum ars [Nat-ar.]

This is a remedy I have prescribed seldom. In my understanding, it should have the main feeling, “I cannot trust and may be cheated by the person with whom I have a relationship”.

The rubrics are:

  • Starting – Suspicious
  • Restless, anxious
  • Frightened easily
  • Fear of people

These rubrics are easily understood in the light of the main feeling. Besides this, Nat-ars has two specific delusions:

  • Delusion neglected his duty
  • Delusion fancies he has done wrong

These two symptoms seem related to the Arsenic symptoms, “Fear when something is expected of him”, “cares for others” and “Delusion he has offended his friend”.

In the second stage, one can expect the Nat-ars person to be very dutiful to his relations (friends etc.) and will be very caring and supporting to them.

He is mistrustful, anxious and irritable. One can also expect the cautiousness and fastidiousness of Arsenic.

Case Example

Mrs. N, a 43 year old housewife, came with the c/o recurrent bouts of dry cough with dyspnoea and pain in the chest. The complaints were night from 11.30 PM to 2.30 AM., lying down and by tea. She had cough as soon as her head touched the pillow. There was involuntary passage of urine with the cough. She feels very hot, sweats profusely and is very thirsty. She is hypertensive (B.P. 190/120) and has a P/H of malaria.

I observed that she was very reserved, answered to the point, sat erect and did not reveal her emotions easily. On enquiry, I learnt that she was extremely fastidious and anxious to get the work at home done on time. She was very sensitive and would remember any hurt for a long time.

Case Analysis

I gave her Nat-ars 200, with which not only did her cough disappear completely, but her hypertension improved to the extent that she does not take anti-hypertensive drugs any longer.

Note: Here, though the patient feels hot, Nat-ars was given. Nat-ars is generally a chilly remedy, but it was otherwise clearly indicated. In general it is important to march the thermal modality, but if a remedy is otherwise very clearly indicated, one single modality should not rule it out.

Kali-ars [Kali-ar.]

The main feeling is that the people (family, group) whose support he seeks cannot be trusted – they could almost rob him any time.

He supports his family a lot, takes good care of them, seems confident and independent. He is the backbone of the family, supporting all of them.

Kali-ars is one of the most anxious patients in the Materia medica; almost crazy with anxiety. He feels weak and needs support (Kali) and yet cannot trust anyone (Ars). He is highly organised, extremely fastidious and very careful and cautious. Very excitable, speaks loudly and anxiously, can get irritated almost to the point of wanting to kill. Quarrelsome with his family, discontented. Feels “when I have done so much for them, how can they do this to me?” Very suspicious. Extremely anxious about his health. Cannot trust his physicians. Avoids people as far as possible. Fearful. Startled easily. His dreams are very frightful “Dream of being pursued, injured, being robbed”.

Indifferent to everything. Suicidal thoughts.

Physical Symptoms:

  • Very chilly; cannot have his legs and feet uncovered
  • 1 – three AM
  • Develops chronic inveterate skin complaints like psoriasis
  • Ulcers and malignant conditions.
  • Sudden noise – a sudden noise throws the whole body into a tremor.
  • Itching warmth (though the patient is chilly)


Mr. N, aged 56, came with the c/o extensive psoriasis that had not responded to any treatment till then. He had been under homoeopathic treatment for a month and had improved a little. As the case was interesting, I wanted to record it on video, and he agreed. As soon as I told him he was to be filmed, he began to smooth his hair. He needed little prompting and began to speak at once.

“For the last 15 years I have had Psoriasis. I tried skin specialists. The skin is very rough, itchy after baths. I apply oil. I get upset. I get nervous to go to places to see people. Since taking the medicine this is better”.

He speaks fast. “The nervousness is also gone. But why has this skin condition come to me? Why is no one able to give me a guarantee that he will cure this disease? I work in a bank. People keep asking me what treatment I am taking and what is happening. I am fed up with these questions. I don’t get any happiness in anything. Because of this skin problem I cannot come into contact with people”.

He complained about his family problems. “I have domestic problems. Everyone is against my views. My mother, wife, sister, daughter – everything is wrong. I get very upset. I am very sentimental. They don’t listen to me. I burn from inside when they disobey me”.

I asked him what does he do in this situation, “I abuse them, I shout at them. I am very particular. I like to have things in their proper place”.

He was sitting in a very tense posture, leaning forward. He looked as though he would be easily frightened. I asked him how he reacted to sudden noise.“I get so frightened that I jump. My heart has become very weak”.

Case Analysis

He asks, “why is no one able to give me a guarantee?” The feeling behind is this is that he cannot trust anyone. He feels he cannot trust the physician or anyone. Wants to cut off from people. But the expression is “Because of my skin I avoid contact”. He is very sentimental and cares a lot for his family. There is a theme of relationships. The feeling here is, “My own family, on whom I shower so much affection, for whom I have so much responsibility, are they dependable? No. They don’t listen to me. No one is trustworthy.”

He is very fastidious and anxious. This makes us think of Arsenic. But Ars does not explain his whole state. There is something more.

There is extreme nervous tension, an extreme state of anxiety, much more than Ars, more intense. This man feels anything can happen. He is very tense. He has some of the qualities of Arsenicum but things affect him greatly. He is not strong enough to withstand the situation of mistrust. Imagine what it must be like – he cannot manage by himself and he is week, dependent. If such a person is surrounded by untrustworthy people what will happen? He thinks, “I need these people whom I don’t trust”.

If the Arsenic person doesn’t get good treatment, he will go to someone else. This man feels that others are letting him down. He is desperate to the point of suicide. Arsenicum is not so desperate. This man is weak, dependent, needs help but feels that he will be let down by the very people he depends on. His anxiety is tenfold – a little sound and he jerks. Totally dependent, totally weak, “My weak heart”, he says. He needs support, needs the family. This is a chronic, desperate situation. The remedy that has this dependency and weakness is a Kali remedy – Kali-arsenicosum.

The rubrics are:

  • Fear: alone, people, death
  • Frightened at trifles
  • Kill, sudden impulse to
  • Insanity, behaves likes a crazy person
  • Suspicious
  • Violent to his friends (single symptom)
  • Dreams of the dead of death of misfortune of fire

In his follow-up he looked relaxed and reported to me, “There is good progress. The skin is smoother and the falling skin (scales) is less. The nervousness has gone, the weakness has gone. I am feeling better. My sleep is good now. I used to get up in the night. My dreams are better. I used to dream frightening things, that someone is following me, that someone wants to kill me. Psychologically I was down. The worry is better now because the skin is better. I didn’t feel good. I didn’t want to meet people. Now I want to talk to people.”

I asked him about his family problems, and he informed me, “That has also improved. I don’t know how. I used to get angry. Now I compromise on things. I wanted to move from Bombay. They used to oppose me. The situation is still there but I am not getting angry. It doesn’t affect me so much. I used to get so angry I could kill them. I compromise, change my mind. I don’t know if it is from your medicine. The face is very clear now. Because the face is clear I feel like talking to other people.”

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About the author

Rajan Sankaran

Rajan Sankaran, MD (Hom), is reputed to be a clear and original thinker and is best known for his path breaking concepts in Homoeopathy. His understanding of ‘disease as a delusion’ followed by his discovery of newer miasms, classification of diseased states into kingdoms and the seven levels of experience, brought in much more clarity into understanding diseased states. The Sensation method has now evolved into a more comprehensive and synergistic approach, which strongly advocates to encompass and integrate the old, classical and traditional approaches with the latest advances.

Dr. Sankaran heads ‘the other song—International Academy of Advanced Homoeopathy’, in Mumbai. This academy primarily focuses on imparting advanced clinical training to students and practitioners, integrated with a homoeopathic healing centre. Also he has his own personal clinic at Juhu area of Mumbai, India. He is also the President of Synergy Homeopathic, which is dedicated to the development of reliable, comprehensive homeopathic software and teaching tools.


  • I relate this to Constantine Hering’s declaration that the best way to study Homœopathy is to first know a few remedies VERY well and then study similar remedies in comparison to them in order to really master the materiel. I hope to master my remedies half as well as you one day, Dr. Sankaran. Thank you for your unrelenting search to make Homœopathy a better science and for sharing your thoughts with us.

  • DEAR DR,

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