Ammonium sulphuricum Case
A woman, aged 60, comes with an ulcer on her left leg, below the knee. It started one year ago in the form of a lump, after she had accidentally knocked it. She has stabbing pains in different spots and the wound is very red. The pain extends to her pubic bone. She feels as if she has a tight band around the bottom of her leg.
She has suffered from sciatica for two years. This is a stitching pain in her left groin, hip and buttock. Sometimes the pain radiates to the outside and the back of her thigh and on to the outside of her ankle. She feels as if her leg will give way, it is heavy and tired. She has the feeling of a band here too. The leg may swell up. The complaints are < going down stairs, stumbling, standing, bending over, getting up after sitting and at night. She also has pain in the coccyx, radiating to the right. Sometimes the pains are so bad that she has to crawl through the house.
Once every three months she has an attack of pain in her back, at the level of the sacroiliac joint. The attacks last about 15 minutes and always happen at night, She feels as if her legs are being pulled out of her body in a sort of cramp. All she can do then is to lie on her knees and elbows.
She also has a pain in her left thumb, < pressure. And a pain in her left upper arm, < carrying a bag.
Tiredness and anaemia; she took iron tablets during pregnancy.
Lump on her left foot.
She sometimes has headaches with floating spots before her eyes, > eating.
Past history: three month ago she had a bad attack of flu, with high fever and much perspiration. Aching everywhere. After this flu all food tasted too sweet or too salty. She got many spots on her legs and the pain in the coccyx also came back.
Her eyes are often burning and heavy. The pain is worse from light and better from closing the eyes. She also has bags under her eyes. She has twice had an eye infection, the first one 15 years ago, whereby the eyes were watering and her vision was very bad.
She gets eczema on her hands from eating oranges and from the medicine 'indocid'.
She has had a wart on her left side.
She once had a curettage after a miscarriage.
As a child she had a crusty eczema on her face. Later on she had severe eczema on her arms, very itchy with yellow pus.
Warts on her left wrist and left wing of the nose.
Her teeth used to be so bad that she has had false teeth since the age of 18. Tonsillitis regularly.
She has a heart murmur.
Constipation.
Bleeding piles, < pregnancy.
Pain in neck and hands before flu, < turning her head.
Family history: diabetes, heart problems, breast cancer.
General characteristics:
Physique: a little fat.
Temperature: warm, < warm weather; she gets sunburnt easily; she loves the rain.
neck pain from draughts, headache before snow, numb fingers, > sea.
Perspiration: on the chest at night.
Desires: sweet (2), eggs (2), chocolate; eats much, drinks little.
Aversion: meat, fish (3), fat, sausage, cake. < fruit, smoke.
Menses: was good; one day before she was a little irritable.
During pregnancy she was tired and anaemic.
Sleep: she sleeps badly, sleeps for an hour in the afternoon, which does her good. She sleeps on the left side.
Mind: she is very open and clear. She doesn’t like hypocrisy, like going to church when you don’t believe in it.
She is very independent. Even as a child she was not easily subdued, not even at her convent school.
Quiet and content. She doesn’t ask for much, otherwise things only get worse.
She used to have a lot of financial worries, over being able to take good care of the children.
She does sacrifice herself a lot. She looked after her father, even though she had four children to take care of.
She likes order.
She likes music, in particular Haydn and other tuneful music.
She is a good cook.
Marriage: She has a good, hard-working husband. He often works at night and at the weekends. But he is very silent. He is there but he doesn’t say anything.
He never speaks about any problems at work or about his health. She therefore doesn’t want to go on holiday together:'I would have to look at a silent man all day'.
The situation of her marriage makes her very sad, but she has suppressed this. She doesn’t really feel the sadness and never cries. Except once, when she heard a song that was called 'I taught you how to love me'. She was also very sad when her brother in law died, because he had been so kind and attentive to her sister.
Childhood: she is the second child out of 7, and she is the eldest daughter. Her mother was introverted and dominant. She was always the one who had to help her mother, much more than the other children.
Analysis
Lachesis seemed an obvious choice for a while, because of the problems in the relationship, the sciatica, left-sidedness, ulcers and warmth.
But the improvement did not really hold, the complaints kept coming back. On closer study there seemed to be a lack of certain essential lachesis traits, such as violence and the jealousy. In this case we see more of a bitterness and reservedness towards her husband. The word resentment seems appropriate.
This grudge against the husband is one of the essences of Ammonium sulphuricum, as we saw in the group analysis. The other symptoms then also appear to fit, the Sulphur side being the complaints of the vascular system, the ulcers, left-sidedness, the desire for sweet and the feeling of heat; for Ammonium we find the sciatica with all its modalities and the aggravation at night.
Reaction
After Lachesis there was either a temporary improvement or a shifting of the problems, for instance from the leg to the eye. Following a dose of Am-s 1M she got a real aggravation for the first time. This lasted for 3 days. After that all the complaints disappeared. She also felt much milder and warmer towards her husband. The resentment had almost gone.