Case 4.12: Chenopodium Anthelminticum
By Guy Kokelenberg (Homeopathic Links)
In the course of our case-analysis, occasionally an unusual rubric will bring a small remedy to our attention. By observation of the patient Dr. Kokelenberg found a strange, rare and peculiar symptom in this patient and from further repertorisation and study of materia medica built up a case for Chenopodium.
This 'detective work' is an exciting part of homœopathy and encourages us to deepen our studies and undertake the pain-staking work of completing therepertory knowledge from different sources of materia medica.
V.M.L., Female, D.O.B. 13/7/19
consultation 17/2/1989 (acute)
Actual complaint
Persistent pains in the dorsal region of her back, pains lasted for about a week. Before consultation, she went to see her physician and received antiphlogistics for dorsal backache, without result, she cannot sleep anymore, the pains last day and night and are now becoming more severe.
The pains are stitching, sharp, worse when moving or breathing deeply, and localised under the right shoulder blade on a small spot. No etiology could be found, warm and cold applications have no influence.
The pain seems to originate in the region of the heart but no other cardiac complaints could be found.
Past history
She has been suffering from Menière´s disease since her early twenties. Her hearing on the right side is totally lost and she experiences a constant ringing noise on that side.
On the other hand there was vertigo that prevented her from going out, she sometimes had more than one vertigo attack a day.
The vertigo was ameliorated after the first remedy she received in 1988. At that time she came for constant sore throats and formation of bad tasting deposits in her tonsils, which she had to clean away.
She had an infectious hepatitis with jaundice when she was 14 yrs. and she suffered from weakness for a long time afterwards, as she remembers no swelling of glands, mononucleosis is not probable.
She lives alone and is helped by her daughters, but wants to remain in control of her household-affairs. Her husband died 12 years ago; she had had a good relationship with him as he had let her make all the decisions.
She occasionally experienced some flatulence, her stools are mostly hard and difficult.
No marked food cravings or aversions. Indifferent to weather and temperature influences. No skin problems, sleeps normally except for the last week due to the pains.
At the first consultation she received a dose of Lyc. 200K with the following symptoms:
noises ringing (Kent (K.) p.298), dictatorial (K. 36), liver and region of (K. 553), stool hard (K. 638), throat hawks up cheesy lumps (K. 453).
There are a few additions to make in this rubric as you will find in the KCR on page 345:
Arg. n (Allen T.F.), Bell (Boericke), Bry (Allen T.F.), Calc.-f.
(Boericke), Coc.-c. (?), Ign. (?), Lyc. (Allen T.F.), Merc. i-r.
(Boericke), Nit. ac. (?), Syc.-co (Patterson), Tub. (?), and a few
cross-references: page 448 Throat, caseous deposits in tonsils.
I had a few follow-ups with her during which her sore throats were less frequent (but didn´t disappear), she suffered less from flatulence and constipation, and most important, her vertigo ameliorated to an attack about once every 2 weeks and no vertigo in between. For that reason she received only placebo till today´s consultation.
Further history
I observed that she was sitting in front of me with her right ear directed towards me, which was not logical as she was deaf on the right side. When asked about it she replied that, although deaf on that side, she was extremely sensitive to noises like traffic noises, ringing of the telephone, dropping a pencil on the desk. She said her deafness was only restricted to the conversation of people.
Discussion
One could of course simply repeat the first remedy in the same dose, but first of all it bothered me that Lyc. was not in the rubric at page 902 (Pain dorsal region, scapulae, right, under). I considered complementary Chelidonium for some time but no valid confirmation for that remedy could be found. In the second place Lyc could not be found in a keynote she mentioned about her hearing, this can be found on page 323 (Hearing.
impaired, voice, the human).
It was not really pain from noises in the deaf ear like Am.c., refer to page 305 (Ear, pain, noises from, in the deaf ear).
In the third place although her sore throats were less frequent, they still appeared and the formation of lumps in the tonsils persisted after Lyc 200K. In the fourth place, but of less importance, Lyc is not mentioned in the rubric on page 294 (Ear, noises, vertigo, with).
But then I tried to find the symptom that she was very sensitive to certain sharp noises, which must be mentioned in the rubric on page 321 (Hearing, acute, noises, to) and not on page 79 (sensitive to noise) as here it is a mental symptom.
And then I found a sub-rubric which interested me a lot as this was exactly what the patient told me:
"hearing acute to the sound of vehicles though deaf to voices" with some obscure remedy behind it that I couldn´t even pronounce! It was however fascinating to find it in the rubric on page 323 in italics. So, I decided to read Boericke about it on page 191. 'Characteristic pain in scapula very marked. Symptoms of apoplexy, right hemiplegia, and aphasia. Stertorous breathing. (Opium). Sudden vertigo. Menière´s disease. Affections of auditory nerves. (Nat. salicyl.). Oil of
Chenopodium for hookworm and roundworm. Torpor of auditory nerve. Hearing better for high pitched sounds. Comparative deafness to sound of voice, but great sensitiveness to sound, as of passing vehicles and also a shrinking
from low tones. Buzzing in ears. Enlargement of tonsils. Aural vertigo. Intense pain between angle of right shoulder-blade near spine, and through the chest'.
You can imagine my astonishment to find out that Menière's disease was mentioned together with about every striking symptom this patient had.
Therefore I gave her Chen. a in 6K (as no other dose was available at thepharmacy) 3 times a day and asked her to phone me if anything changed.
Follow-up
The patient took the remedy on Friday and slept through the night without waking from the pain, this was for the first time in two weeks. The following days the pain progressively disappeared completely and on Monday she phoned me and was instructed to stop taking the remedy. She said she
felt more sleepy and had to take a nap after dinner. I frequently observed this symptom in patients who received their remedy, after a few days this sleepiness disappears, probably it is a revalidation sign.
I saw her again after a week on 24/2/1989 and she said she suffered no more pain and felt quite well now. The advice was to wait and come back in a month to evaluate the case.
She came again on 29/3/1989 and had experienced no problems. She made the remark that she didn´t have a vertigo attack during that period of time. Her hearing problem had not changed and the noises in the right ear were still there. No prescription, next consultation in 2 months.
Saw her again 27/6/989. She came later because she felt well. No new signs except two things she had remarked: she had only two vertigo attacks during the whole period and they were short-lasting and not so severe as they were before. Secondly the formation of plugs in her tonsils had completely disappeared and thus no more sore throats. Rx: No remedy, wait and come
back in 2 months.
She came back on 02/09/1990 accompanying her grandson who came for a consultation. No problems occured in the mean time, only one more vertigo attack in December after drinking coffee at Christmas. She experienced to be less sensitive to noises of traffic, telephone, doorbells etc., but her hearing problem did not improve. The formation of plugs in the tonsils did
not come back. The pain in the dorsal region did not occur again.
Conclusion
It is not always necessary to bombard our patients with the highest doses, a deep constitutional treatment is possible even after a few doses of a low dynamisation (6K).
Use of the Repertory alone is not enough, knowledge of Materia Medica must lead to additions to the Repertory to enable us to find the correct rubrics and thus the correct remedy.
Small remedies are only small because we do not know them, once we know them we are confronted with the amplitude of their work.
Very frequently we only find the correct remedy thanks to an acute illness of the patient, therefore we should organise our practice so that acute cases can be seen without delay.