Case 1.17
A 29-year-old woman with symphysiolysis pubis during her third pregnancy.
Two years back she consulted with me because she was very tired, with daily headaches due to hard study. She even considered quitting her studies entirely. She responded well to Calcarea phosphorica 200K.
Coming now with pains in the symphysis pubis, it would be very logical to repeat Calcarea phosphorica (Kent: pain pubic region; Boericke: soreness in sacro-iliac symphysis as if broken). But there were four reasons why I decided to give a different remedy:
- One was that, although she responded quite well to Calcarea phosphorica in the past, I never felt really comfortable with the remedy. The remedy fitted the headaches due to mental exertion, but the central idea of dissatisfaction and a desire for change was absent. Calcarea phosphorica was the best I could think of at that time.
- The second was that she reminded me a lot of the woman described in case 1.
- The third reason was that in my experience with pubic complaints so far, Calcarea phosphorica is called for when there is pain in the pubic region, and less when a sense of instability and looseness is prominent.
- The last reason was that when there is an option of prescribing a lesser known (smaller) remedy, curiosity makes me decide in favour of that remedy, certainly when I don't feel totally comfortable with a well-known remedy
(polycrest).
She felt looseness in the pubic bones since the twentieth week. The complaints are worse lifting and when lying on her side. She said, 'My attitude is one of not complaining; things can be worse. I just go on'.
After her first delivery she lost a lot of blood and fainted. It took three quarters of an hour before the placenta came loose. Her mother also lost a lot of blood during delivery, and went into a coma once. It always took a very long time before the placenta was delivered. Her grandmother almost bled to death after each delivery.
Rubrics containing Trillium pendulum:
* - EXTREMITY PAIN; BROKEN, sensation as if; Pelvis, as if falling apart * - EXTREMITIES; DISLOCATED feeling; Hip
* - EXTREMITIES; WEAKNESS; Hip
* - FEMALE; PAIN; sore, tenderness; Pelvic bones
* - FEMALE; RELAXATION of genitals; pelvic region
* - GENERALITIES; BANDAGING, amel.
* - GENERALITIES; BINDING UP, bandaging amel.
* - GENERALITIES; FAINTNESS, fainting; hemorrhage; post partum
* - GENERALITIES; FAINTNESS, fainting; loss of fluids, from; blood
* - FEMALE; ATONY of Uterus, inertia uteri
* - FEMALE; LOCHIA; bloody, too
* - FEMALE; LOCHIA; prolonged
* - FEMALE; LOCHIA; protracted
* - FEMALE; LOCHIA; copious
* - FEMALE; METRORRHAGIA; labor; during and after
* - FEMALE; METRORRHAGIA; women; habitually flood after every delivery, who * - FEMALE; PAIN; sore, tenderness; Pelvic bones
- FEMALE; RELAXATION of genitals; pelvic region
Appearance
She comes across as being intelligent, thoughtful, controlled. Picks out her words with great care. She seems somewhat tense. Regularly she takes one of her lips between her teeth and bites them gently. She comes across as being resolute and correct. She is a teacher of Greek and Latin. 'So I can, without holding back, give in to my urge to explain. When I was a child, I taught my sister how to read.'
She was the eldest child in the family. Her parents were both still studying. 'Actually I was not a child; I always wanted to be a grown-up.
I'm so happy that I'm an adult now. I was inquisitive and a know-it-all.
"When I'm an adult I will know all the words," I thought. I wanted to be independent, make my own choices. But I'm also very law-abiding. Getting a reprimand meant not being more part of the group, being excluded. It was important to me that my parents liked me. Their opinion is still important to me. My mother always said not to have children before I finished my studies. I was very bad at gymnastics and did very well in mathematics and languages. I even wasn't able to throw a ball properly.'
Because she was very ambitious, she got all her swimming diplomas and even a black belt in judo. 'I do judo not for relaxation, but because I need a goal.' She always wanted to get high marks, and her first unsatisfactory mark was a great trauma to her. She had a great fear of failure, 'Of not living up to the image I've created of myself towards others'.
'I always want to be in control, to know what will happen next.'
Owls
Of course, thinking of prescribing Trillium pendulum for her, I was very anxious to know whether there was anything with regard to owls. But to my open question whether animals meant anything to her, she only narrated her fear of dogs as a child. At last I asked her bluntly about owls. She said:
'There is nothing about owls in particular. But I feel very much drawn to Pallas Athena, and she has an owl as her symbol'. I ask her what in Pallas Athena was so appealing to her. 'The thoughtfulness, the intelligence.
Always working according to a plan. She does not allow herself to be distracted by beautiful men like Aphrodite, nor by futility like Artemis, who went into a rage because of the killing of a little deer. She admires astuteness in people. She can admire a human being who is lower than a god because of his qualities. She is not jealous like Hera who let off steam on those poor little girls.'
To me, this whole description sounded a lot like the patient.
'I never have arguments. First I calm down and think it over. I've always thought it very childish when people fight'
I prescribed one dose of Trillium pendulum 200K.
Follow-up after six weeks
The next day the sense of looseness was almost completely gone. 'At some point it even felt more tight instead of loose.'
'My dreams have changed. I used to have dreams of situations where things get out of control, in which you do not know what to do anymore. I would wake up from those dreams angry and irritated. A sense of despair, of not knowing a way out.'
Follow-up after six months
Pelvic problems are fine. Only after sliding the problems returned, but disappeared spontaneously again.
Delivery
When her delivery was due she repeated the remedy in a 200K, and again, immediately after delivery. The placenta was born spontaneously after twenty minutes, and the loss of blood was less than 500cc. The uterus came back to its normal size quickly, and the lochia stopped within a few days.
The pelvis felt loose for a few days, but that improved rapidly.
Follow-up after eighteen months
The symphysiolysis complaints never returned. Now she has strained her wrist. 'It feels exactly the same as pelvic instability.' Trillium pendulum 200K was repeated with good result.
Pallas Athena
In Greek mythology, Athena was the patron goddess of Athens and an important member of the Olympic pantheon. She was the daughter of Zeus and Metis (the mind). Zeus was afraid that his daughter would take his place, so he ate the pregnant Metis. Zeus had a terrible headache, and asked Hephaistos, the blacksmith to split open his forehead (like the cleft pelvis) with an axe. So Athena was born out of Zeus' head (the mind), an adult woman (the women in both cases wanted to be an adult during their childhood), in full armour (tight bandage). She was her father's favourite child. He entrusted her with the aegis, his breastplate, and with his terrible thunderbolt.
On the one hand, she was a warrior figure, and most images depict her dressed in armour and holding a spear. On the other hand, she took an interest in handicrafts and agriculture. The olive tree, which she has said to have created, was sacred to her. She was also noted for her wisdom and good sense. This explains her close association with the owl, an ancient symbol of wisdom and reason. She was also called 'the girl with owl's eyes'. (EYE; ENLARGEMENT; sensation of)
The Parthenon, still standing atop the acropolis in Athens, once contained a monumental statue of Athena Parthenon (parthenos = maiden). But she was the patron goddess of many more cities. (again holding together, just like the walls that protected ancient cities)
Conclusion
I have more cases of symphysiolysis in which Trillium pendulum worked very well, but only these two cases were indicated constitutionally, and acted accordingly. With a clinical approach, one could say that Trillium pendulum is the Arnica of pregnancy for pubic pains and pubic instability. The remedy rarely fails to act in these cases, which to me indicates that often these pelvic complaints should be considered more as a trauma, and therefor a layer to the constitution. My approach is to first see whether there is a clear picture of a constitutional remedy, and to follow with a specific remedy in case the constitutional does not act well enough for the pelvic complaints. In my experience Trillium pendulum is the most indicated specific remedy for symphysiolysis, and colleagues with whom I have shared my experiences have reported similar results. A traumatic event to the pelvis can also be an operation in the region. I have used the remedy with good results in a constitutional Tarentula with pelvic pains and a sense of looseness after surgery.
Differential diagnosis
For pelvic disorders the following remedies can be considered: Calcarea phosphorica
* - Soreness in sacroiliac symphysis as if broken (Boericke)
* - Pain pubic region (Kent`s repertory)
* - Pressure over os pubis during menses (Knerr)
* - A kicking quivering over os pubis (Hering)
Murex
* - Walking difficult, all joints weak during pregnancy. As if bones of pelvis were getting loose. (Phatak). Murex is an alternative when the sensation of looseness is prominent and Trillium pendulum does not act, or when the sensation of looseness is accompanied by bearing down sensations.
Sabina
* - Pain from sacrum to pubis and from below upwards, shooting up the vagina
* - Pain from back to pubis, or reverse
* - Aching pain in sacrum as if broken and as if the bones would separate. (Boericke)
Aesculus hippocastanum
* - Constant throbbing behind symphysis pubis.. lameness of back across the sacroiliac region.. as though the legs were about to give out(Concordant MM Vermeulen)
Bellis perennis
* - During pregnancy inability to walk (Concordant MM Vermeulen)
In constitutional cases the characteristic 'amelioration by bandaging' can also be understood in a broader sense. Not only is the pelvis held together by a tight bandage, also the emotions are held together by a controlling mind.
Apart from pelvic pains and instability, Trillium pendulum is an important remedy for haemorrhage, especially from the uterus after delivery (see cases) and after abortion. Haemorrhage causing faintness.
The remedy should probably be added to the rubric: 'Placenta, retained'.
Mind picture
With a lot of caution (two cases is an uncertain ground for generalising to conclusions) I postulate the following characteristics of Trillium pendulum in women:
* - Controlled (the remedy could be added in: MIND; EMOTIONS; predominated by the intellect), composed (an interesting rubric in this respect is: MIND; QUIET; disposition; abortion, with threatening), thoughtful, systematic, well-behaved, conscientious, responsible and intellectual people.
* - They are ambitious and do not like to be dependent or restricted.
* - They tend to just go on, to deny the needs of the body. They have an aversion to being hindered or stopped by bodily complaints. They can even separate themselves from their body or their emotions (MIND; CONFUSION; identity, as to his; duality, sense of).
* - They do not like childhood, but want to be adults as soon as possible, to possess the full capacity of their mind.
* - It is very important for them to combine their motherhood with a career. They really want to be a very good mother, but also having children must not hinder them in pursuing their goals, in having a career.
* - They are very much oriented to the intellect. With their intellect they control their emotions, so also emotions can not make them deviate from their course, or bring them out of their self-composed equilibrium.
* - They dislike quarreling and do not allow themselves to be carried away by their emotions; this makes them suited to helping others solve conflicts. Conflicts should be solved in a rational, rather detached way.
* - When a woman is so focused on her head and intellect, pregnancy and delivery can be quite a challenge. They have to bring their energy down to the lower half of their body. Delivery is more animalistic, quite opposite to their nature of intellectual composure.
* - Pallas Athena is their patroness and the owl their symbol.