QUARTERLY HOMOEOPATHIC DIGEST

Vol. IV No. 2 June 1987

CONTENTS

1. A CASE OF DIABETIC PERIPHERAL NEUROPATHY TREATED WITH ZINCUM MET.IN LOW POTENC

2. THE EFFECT OF FREQUENT REPETITIONS OF HIGH POTENCY PLATINA IN AN ADOLESCENT BEHAVIORAL PROBLE

3. TAKING A HISTORY

4. HOMOEOPATHY IN ALLERGIC DISEASES

5. ARSENICUM ALBUM IN LICHEN RUBER PLANUS

6. AN INTERESTING CASE OF ANGINA PECTORIS

7. ROUTINE TREATMENT OF MEASLES?

8. ROUTINE TREATMENT OF SCARLATINA?

A CASE OF DIABETIC PERIPHERAL NEUROPATHY TREATED WITH ZINCUM MET. IN LOW POTENCY

R.A.K. JACK

Mrs. M.G., age 44, first consulted me on 20.8.82 and gave the following history. She had suffered from diabetes since 6 years old and had insulin twice daily for the last 37 years, including 32 years on protamine zinc insulin. All this time she had been under regular hospital surveillance, and was currently maintained on on insulated (pork isophane insulin) 40 strength, 9 units b.d. Her diabetes was still unstable, she could not control her glycosuria satisfactorily, and still had severe attacks on hypoglycaemia. (she failed to keep one of her subsequent follow-up appointments because on that morning her husband found her nearly unconscious, and just managed to get sugar into her before the ambulance arrived inresponce to his 999 call.) Ten years ago she had developed severe diabetic peripheral neuropathy, and in recent years had a frozen shoulder (left), a transposition of her left ulnar nerve (1981), and an operation for a left median carpel tunnel syndrome (1981). To add to her problems she suffers from angina pectoris and fluid retention. For the previous year her medication had been : Dolobid (diflunisal) qid. Feldene (piroxicam 10 mg) tid. Distalgestic (dextropropoxyphene) 8 tabs daily Sectral (acebutolol) 100 mg daily Frusemide 40 mg on alternate mornings, alternating With Moduretic (amiloride and hydrochlorothiazide).Despite this heavy dosage with analgesics she was still in considerable pain.

She complained of :-

1. severe pain “like someone permanently sticking needles in the soles of my feet’s and “like electric shocks in my legs and bottom”, especially severe at night, and on waking. The pain was better by cold, so that she spent most evenings sitting on rubber ring with her legs exposed.

2. Severe cramping pains on sitting, necessitating constant changing of position. She had to stop the car three times during the 20 miles journey to her consultation, and be helped out, to stretch her legs, to ease her pain. These pains began about 10 years ago,

but had been very much worse for the last year.

3. Loss of sensation in her legs, and loss of balance after sitting so that she had “to be helped to get balanced on attempting to stand up and walk”. She was only able to walk about 20 yards.

4. Total bilateral anaesthesia of lower limbs, up to her thighs. (she demonstrated how she could insert a hypodermic needle full length into different parts of her thigh without any feeling of pain).

5. Inability to dorsiflex her ankles, so that in the days when she was still able to drive, she had to lift the whole of her foot off the pedal.

6. Inability to stand unless wearing shoes with adequate high heels.

7. Paraesthesia of upper limbs. “My arms go numb, so I don’t know where they are”. “It makes me drop my knitting”. Wrists and fingers stiff and numb on waking, with “jumping pains” better by movement.

8. Dependency on others, needing help to get up in the morning and and dress. “ I have to come down stairs on my bottom”. “All joints from the waistdown are painful and stiff on waking”, necessitating movement to ease.

9. Profound lassitude.10. Ulcers of her ankles and feet, and recurrent

sepsis around her toe nails. The ulcers started about 5 years ago, invariably following minor trauma, lasted 6-8 weeks, and there was usually at least one present at a time.

11. Fluid retention. “If I don’t take my diuretics I rapidly gain 2 stone (12.7 kg) in weight.

Treatment : As her most pressing need was for relief of pain, I prescribed mainly on her particular symptoms : 1. Phytolacca 3rd qid until improvement.2. If no response after 10 days change to Agaricus 3rd qid. I instructed her to continue taking all her conventional medication, explaining that in her case homoeopathic medication was an additional therapy, but that she could reduce the analgestics if she found the pain diminishing.

Phytolacca in its provings produces:

Shooting pains like electric shocks, that radiate, Especially in the distribution of the brachial plexus, And sciastic distribution.

Rheumatic type of pains—very like those produced by Rhus tox., i.e., Worse a.m.worse wet worse cold worse night Better warmth better dry but are worse motion (like Bryonia) In the united states of America the fruit and root of the plant have been used to relay pain, and as an antirheumatic. Agaricus (which contains muscarin) in contrast produces :

Jerkings, twitchings, trembling, chorealike movements, and itching. Neuralgia—painful spasms, tearing pains, with numbness, Coldness and tingling worse cold better movement Paralysis of lower limbs Pains as if pierced by needles of ice Itching of toes, and feet, as if forozen—burning, Itching, redness Swelling as if from frost bite (hence its use homoeopathically in the treatment of chilblains) Ataxia

At her second visit 2 months laer (22.10.82) she reported :

Slepping better Discontinued all dolobid and feldene, and reduced distalgesic from 8 to 2 daily. “I have only taken 4 in last 4 days”. She considered Agaricus helped more than phytolacca, And after 3 weeks has reduced the dose to Agaricus 3rd One nocte only. “It stops me waking yp”. She could not sit for short spells without her cushion

Rx Zinc, - met, 200 * 1, repeating every 14 days if required.22.12.82 “Zinc. Helped for 3-4 days , but best,

improvement came after reverting to Agaricus”.

“Occasionally wakened by restless legs, then I have to walk the room”. Rx Zinc. Met, 10M *1 and try Zinc. Met. 6 tid in place of Agaricus.

19.1.83 “Zinc. 6 suits better than Agaricus 3rd.” She c/o burning, swollen, hot, stinging wrists, swollen feet and ½ stones (3.2.Kg) weight gain each evening (despite diuretics) which disappeared each morning. Rx Apis 3rd qid until relief.

2.3.82 Discontinued all conventional analgesics for last 3 weeks. Apis relieved both wrist pains and fluid retention dramatically.

“I can now move easily, and walk 50 yards, the best for over ayear.” “I have no jumping pains, and the numbness is considerably improved.”

9.5.83 No analgesics for last 3 months. Sleeping more comfortably—less dependent, more mobile. Takes Zinc. 6.q.h. 1- doses on days when returns, on average on four days each fortnight. She stated that one or two doses of Zinc.6 predictably stopped her pain. However, she complained of persistent dyspepsia for last month with hunger pains, eased by Tagament(cimetidine) and Maxolon (metoclopramide).She was awaiting a cholecystogram.she was intolerant of fats, admitted to being “wet eyed” (found her eyes watered when saw, or heard anything moving or touching); she liked change. (“My husband is often surprised when he comes home, because I’have had the furniture rearranged.”)Rx Pulsatilla 30qh until reaction.

14.5.83 Five days later she attended the Midlands Branch Tutorial at Selly Oasis Hospital as a case demonstration.

she started her dyspepsia was already much improved, “better than in all the previous month”.In the discussion that followed, Dr. Mollie Hunton observed that there was a relationship between plasma Zinc levels and healing of ulcers, and asked if the patient’s ulcers has improved since using Zinc.6. On learning that there had been no significant change, she suggested giving dietary zinc. Dr. Anita Davies, who made a video recording of the demonstration, commented on the balance between zinc and copper in the body, and that the body used up a lot of zinc in healing ulcers. She suggested that a plasma Zinc estimation might be of value.

12.9.83 Patient is still controlling her neuralgia adequately with zinc. met. 6. “These pain goes within one hour of taking a tablet.” Her cholecystogram and gastric investigation were all unremarkable.

11.10.83 Not taken any conventional analgesics for the last 8 months.

Pulsatilla no longer eased her dyspepsia, but surprisingly she found that Zinc mets.6 did, and was more effective than Maxolon. She needed to take it qid, otherwise her gastralgis

lasted for hours. Her neuritic pains were still control effectively with Zinc. She could now walk3/4 of a mile—a big improvement on her original limits of 20 yards. Discussion

McLeod states that “the most common form of peripheral neuropathy in diabetes llitus is a symmetrical, predominantly sensory, polyneuropathy. When there is severe sensory impairment, perforating ulcers of the feet and neuropathic joints may occur, both associated sensory ataxia (diabetic pseudo-tabes). Motor and sensory conduction are impaired.

“Isolated peripheral nerve lesions are common, particularly carpel tunnel syndrome, nar nerve lesions at the elbow are radial, feromal and lateral popliteal nerve lsies.”

The same author lists the metals and industrial agents that cause peripheral neuropathy, and includes arsenic, lead, mercury, thallium and gold (but not zinc)

The reason I considered Zinc. met. might be even more effective than Agaricus was cause of two previous occasions when I had prescribed it for diabetic patients with peripheral neuropathy. Both had received protamine zinc insulin (PZI) for many years, and both found that low potency Zinc. met. afforded considerable relief. This patient had PZI for 32 years, and displayed several of the features one associations with the provings of Zincum : Severe pain, twitching and trembling of her lower limbs with marked weakness. Pain temporarily relieved by motion, making her constantly move her legs and change position (“restless legs”, “fidgety feet”). Very sensitive soles of her feet. Profound prostration,”feeling totally exhausted”, with mental apathy. Dyspepsia. She claims that Zinc . affords more relief than Agaricus, which certainly helped her.

Summary

This woman was presented at our Tutorial, for teaching purpose only, and not in an attempt to prove that Zinc. met. in potency would predictably alleviate, or improve diabetic neuropathy. It is interesting to speculate on the possible association between her prolonged use of PZI and the apparent benefit she obtains from low potency Zinc.

It is also worth observing that it often happens, as in this case, that more than the drug in low potency may help a patient, though none

may be the exact similimum; previously the one whose side effects most effective. Finally, this patient found more benefit from low potency Zinc. than high—confirming common experience that where there the advanced pathological change, with physical rather than mental symptoms, low potency describing is generally the most successful.

[From THE BRITISH HOMOEOPATHIC JOURNAL, Vol.73, No.1 January 1984; for private circulation only) ----------------

THE EFFECT OF FREQUENT REPETITIONS OF HIGH POTENCY PLATINA IN AN ADOLESCENT BEHAVIORAL PROBLEM

William Shevin, M.D., D.Ht. (The following paper was presented to the December 12, 1985 meeting of the Connecticut state Homoeopathic Medical Society. Participants were, in addition to Dr. Shevin, T.C. Cherian, M.D., Ahmed Currim, M.D., William F.McCoy, M.D., and PercyRyberg, M.D.)

INRODUCTION : This paper is a report on R.M. who was born on January 12,1968 and who first consulted me with his mother on August 8, 1984. His chief complaints were : 1) “confuse” feeling since the fall of 1983, 2) constant fatigue, 3) recurrent low fevers sometimes accompanied by streptococcal infections mostly in the winter, and 4) headaches.

In childhood, he had chickenbox, but was otherwise healthy. Somewhere around 1982, he rebelled against his father demanded good marks. The patient had always wanted to go to military school, and believed his father would support him financially. There was great disappointment when his father refused to do so. He became furious, but did not direct his danger towards the father. In September 1982, he developed fatigue and sore throat. The diagnosis of a streptococcal throat was made and was treated with antibiotics. In November 1982, he developed dizziness which he described as a sudden “spinning, black hole”. There was no loss of consciousness. He also had nausea and blood in urine although not much detail is known about these last symptoms. As of January 1983, he continued to be fatigued. Mononucleosis was diagnosed. No treatment was offered. By August 1983, a confusional state became more prominent, which I shall presently described.

Somewhere in late 1982 or early 1983, he began to crave sweets intensely. He would hide abox of cookies in his room and consume them all at once. After the intake of sugars, he became increasingly fatigued and would sleep for up to 16 hours; he would experience a “confused” state of mind.

“Confusion” means, in this case, “strange thoughts.” “For example, while walking down the street he imagined that a telephone pole would leave the sidewalk and obstruct is path, or that he would be run over by a car even though there was no car in sight. There was no anxiety with these thoughts. Following such thoughts would come a state of feeling very powerful, very strong.” A good feeling, like I could do anything Iwanted do.” “Very much in control.” Sometimes he would go out in the woods with friends and shoot animals. Once they physically abused a schoolmate, but generally the violence took the form of killing animals. This state would last for approximately 24 hours, and there was no remorse following it. He became “addicted” to classical music, listening to “stormy” music (Wagner) for hours on end. He tended to separate from his friends. He didn’t like people and feel that the music was only thing that mattered. He felt that other people were “beneath” him and sank into a rather depressed, fatigued state. He felt much, much better if he lifted weights vigorously, or during thunderstorms. He read a lost of historical novels focusing on Hitler, extreme violence, bloodshecd, etc. He developed fantasies of killing which by the end of 1983, he was acting out as described above.

In December 1983, his mother diagnosed hypoglycemia and instituted rigid control of his diet. This resulted in great improvement of his symptoms. The depressive state with great interest in violent music, subsided. He became less violent, but was still fascinated by Hitler memorabilia and had a pedestrian might step out in front of them, he delighted in describing , in gory detail, the consequences of them hitting the person. If he did eat an appreciable amount of sweets, he would become confused, developing feeling of “power”, as described above.

FAMILY HISTORY

Many relatives on the father’s side had allergies (pollens, grasses, etc.). His mother had eczema as a child. One grandfather had amyotrophic lateral sclerosis.

Hunger made him “weak” and produced a feeling of “don’t give a damn,” plus defiance. Other than the symptoms described above, there was very little else. He appeared somewhat bored during the interview and clearly felt that he was just talking to humor his mother. He didn’t feel he had any problems even though he was willing to describe his feelings freely to me. To the question: “How do you cope with stress and conflict?” he answered, “I meet it head on and destroy,” or “I fade out go into a world where I win.” Despite his symptoms, he really felt that he was in great health. He appeared very muscular, calm, slightly aloof. His goal was to be a jet fighter pilot in the Air Force. Physical examination was unremarkable.

I was struck by the air of superiority of this child. He felt that everyone else in his grade was “stupid” and that he was biding his until he could get into the Air Force. He felt all-powerful. This lead me to consider platina. Hering’s guiding symptoms lists the following.

- Attacks of cheerfulness; feeling of strength. - Great indifference. - Arrogant, reserved, absent-minded. - Pride and overestimation of one’s self; looking down with haughtiness on others. - Very peevish and easily excited; he could have beaten anyone without provocation. - Everything seems strange and horrible to him. - Sits alone, sad and morose, without talking. - Illusions of fantasy on entering the house after walking an hour. - Talks almost continually about fanciful things or such as having really occurred. - Mental disturbance after fright, grief, or vexation. Hering makes no mention of complaints following hunger, craving for sweets, aggravation from sweets, atc. Platina also tends to have many symptoms of anxiety which were completely absent from this case. The lack of moral feeling was prominent. I also considered Anacardium, sepia, and Lycopodium. On August 14, 1984, I gave one dose of platina 30c and asked the mother to call back in three days.

When she called, she said that she had noticed a “drastic” change in her son. For 24 hours following the dose of Platina, “I had my old son back”, He became considerate. More open, etc. She noted that on a car trip, he was concerned about some pedstrains, warning her to watch out for them. I ordered platina 30C once daily.

SEPTEMBER 12, 1984: He started “Platina is great.” When eating he still reacted, but much less so (50% decrease). He said, “It brings me down to earth. I’m not living in my imagination.” He was not reading Hitler stories any longer. Now he has reading The Hobbit, and mystery stories. He said his “purpose” in selecting reading materials had changed.

Over the next few months, he continued to do well. Platina was continued on a daily basis, raising the potency from 30 to 200, then to 1M, and by the end of December 1984, He was taking platina 10M daily. If he forget it for a few days, his mother noted the return of symptoms. He bagan to get a few sore throats reminiscent of those he had gotten in 1982, but the treatment regime was not changed. The sore throats were all mild.

JANUARY 21, 1985: He had been off the platina 10M for two or three weeks and was starting to regress. Platina 10M was restarted and he improved.

MARCH 26, 1985: Still taking platina 10M, but regressing . My analysis was that either he needed a higher potency or was proving he remedy after virtually continious dosage for seven months.

I discontinued platina.

APRIL 29, 1985: All symptoms subsided within one week of discontinuing Platina 10M. On the rare occasions when he did eat sweets, he had no adverse reaction unless he ate chocolate. In that case, within three minutes, he had the sudden onset of sharping stomach pains with slight nausea and dizziness. These feelings tepered off after approximately 30 minutes.

He enlisted in the Army with the goal of going into military intelligence, the to “crack down on some communists.” His mother (a social worker) was completely satisfies with his status. She felt that he was completely back to normal and that his interest in the military was acceptable. He was caring towards her and his sister and doing well socially.

SEPTEMBER 23, 1985: He continues to do well. Concerning his reading materials, he stated: “I’m getting tired of serious murder mysteries. I want something more fun. As usual, with the onset of cold weather, he felt slightly less energetic, preferring to read. “Everything goes by slowly,” he said. His mother felt he was continuing to do every well. He had not eaten any chocolate.

(At this point in the meeting Dr. Shevin stepped down and a general discussion ensued. William Franklin McCoy, M.D., was the first to comment)

Thank you for presenting this fascinating and instructive case. We in America and not used to the treatment of chronic cases with the frequent administration of high potency homoeopathic remedies. However, in India, this form of treatment is not unknown. Dr. Maganlal B. Desai (1906-1971) read a paper to the International Homoeopathy congress in New Delhi in 1967 entitled “Frequent Repetition of High Potencies.” Another of his Papers, “Use of High Potencies and Repetitions”, appeared in the Silver Jubilee Commemorative Souvenir—1948-1973 issue of the Homoeopathic Sandesh.

Dr. Sarabhai Kapadia, a student of Dr. Desai, reported his experience in the frequent repetition of high potency medications in Area c-4 of Symposium 1 of the Institute of clinical Research in Bombay (Copyright I.C.R., Bombay : symposium council May 1978). In that paper, DR.Kapadia started : “Dr. Desai experimented in the use of high potencies in repeated doses over a prolonged period of time. I have also followed this method consistently and find it highly effective as well as safe in all curably diseases. In incurable diseases with advanced pathology, however,l it does hasten the destructive process that is already in operation andf produces what is known as ‘killedhomoeopathic aggravation.” He further elaborated that in such advanced cases, the physician should put the patient on the trail prescription oif the 30th poency to determine curability.

The question I have with respect to long term daily administration of high potency remedies to patients concerns the question of the possibility of “grafting” a remedy onto one’s constitution which has been described in the literature with respect to such remedies as Lachesis, Silica, and Thuja. Is it possible that such grafting occurs because the remedy was close enough to what the patient needed, but far away enough to be a mismatch? I do not know. Dr. Kapadia’s experience encompassed 25 years with no reports of such grafting.

Returning to the case Dr. Shevin has presented to us, one question might be: Was the use of a nosode considered? Another might be whether the patient was given Sac.Lac.?

Ragardless of the answers to these question, I cannot argue with success, and

commend Dr. Shevin for presenting a case which is sure to stir the pot, so to speak.

Dr. Ryber : This is not a clear-out schizophrenia, as such , according to what is described. There is now a term called schizophreniform disorder, in the DSM.III, where this patient would be classified. I am struck by the issue of hypoglycemia in this case as I am biochemically oriented. The confusion and fatigue, lasting up to 16 hours, is unusual for mani-depressive disorders. When I did many glucose tolerance cases, found many flat curves, especially in alcoholics.

Dr. Cherain : This is a very miasmatic case. This is a sycotic miasm. Bonded psora, we see this desire to kill animals. They want to be like a Hitler.

Dr. McCoy: Dr. Shevin poses the question of whether the patient is cured. It seems to still have certain violent tendencies.

Dr. Cherain : I still wonder if this case is cured. For this reason I have consider animiasmatic remedies to follow the platina.

Dr. Currim : I thought the prescription platina was a good once in view of the fact that the patient improved. I believe that he is using the approach of Dr. Eizaga with the daily repitations. I don’t know, in view of the patient’s response, whether I would have raised the potency the way he did. Perhaps he might have tried repeating less often the higher potencies. With Kent’s method, you give one dose and wait and when the symptoms return, you repeat. On one occasion here, the patient had been off the 10M potency, in January, and relapsed. He could have done this all throughout. It is also possible that the patient may need Licopodium as a constitutional remedy following the platina. The craving for sweets in this case is so intense that the Patient would get a box of candy and hide it in his room and then eat it. But if look under the rubric cruelty, you have Nux vomica, which also has the craving for sweets, although not as intensely as Lycopodium, and is also a remedy of cruelty. So would consider the Nux vomica. One other symptom in this case, the sensitivity to music, is a strong symptom of Nux vomica. My may need a nosode, possibly tuberculinum of Syphilinum.

But his first prescription was agood one. Atleast the remedy choice was excellent. He describes how he located he remedy under the delutions of superiority with platina the only remedy.

Later comments by Dr. Shevin: Unfortunately, I was not able to be present after the meeting. I would like to address some of the questions raised in the discussion. It is true that I had attended Dr. Eizayaga’s seminar two months before seeing this patient and I did tend to start patients with lower potencies (6-30) on a repetitive basis. In this case, however, I elected to give a single dose of medicine. I spoke with the mother a few days later. She had seen a very drastic change with lasted only one day. At that point, based on my experience with repetition over the previous two months with other patient, I elected to repeat the remedy daily.

The regiment waqs adhered to reasonably well, but he did tend to relapse when not taking it. At first, these relapses were within just a few days, but gradually the remedy effect was noticeable for increasingly long periods of time ater cessation (because he would run out of medicine, or forget to take it because he was feeling well etc.). I raised the potency whenever there was a relapse (even though he was taking the medicine daily) or if, after atleast several weeks on a given potency, I felt he was not making enough progress. This is my understanding of Dr. Eizayaga’s technique. The patient continued to improve and stayed on the 10M potency for quite a while. When he bagan to get symptomatic again, despite baing on the 10M potency, I felt somewhat reluctant to push him up to the 50M, a potency I rarely find necessary to use. A drug free trail was instituted and the symptoms cleared; he was remained well since.

The term “well” in the above paragraph needs clarification. I still feel that there is a very low-grade illness here. I am particularly grateful to the suggestion of Dr. Cherain and others that a nosode might be in order, or some indicated anti-sycotic remedy. His mother, however, feels that he is completely well. She is not unmindful of his reasons for being the intelligence branch of the armed forces, but feels that this is acceptable to her. There are some philosophic questions raised in this situation about the physician’s judgement of “cure” as related to “moral” judgement. At this point, I am basically waiting to see how the case is unholds.

The selection of platina was based on the strong feeling I had that the main presenting symptom was the arrogance and feeling of superiority. I do not feel that it would be justified, as yet, to consider the inclusion of platina in the rubric “Desire sweets” and “sweets aggravate,” even though these two symptoms appear to be almost completely clear. “Almost”

is the operative term of in this discussion. There is still some reaction to chocolate and sweet cravings seem to be virtually absent.

As to the allopathic diagnosis, I consider bi-polar illness and schizophrenia and being the proper diagnostic categories, but could not make either of those on the basis of his condition of my first visit. Reactive hypoglycemia seemed a more clear-cut diagnosis as well as food allergy.

[From the JOUNAL OF THE AMERICAN INSTITUTE OF HOMOEOPATHY, vol. 79, no.2, June 1986, for private circulation only].

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TAKING A HISTORY

H. MORROW BROWN MD, FRCP. Emiritus consultant physician, Derby hospitals and Consultant and Research Director, Midlands Asthma and Allergy Research Association.

SUMMARY : The taking of a clinical history is of paramount importance in the investigation of any allergic or suspected allergic situation because it is essential to recognize a demonstrable and a repeatable cause/effect relationship. Guidelines to taking stories and key questions which should be asked are given.

CARELESS usage of the word ‘allergy’ by the laity and the media has blurred the running of the word, but its implications are readily understood by everyone: allergic patients are abnormal in that they produce exaggerated self-damaging defence reactions substances which are tolerated perfectly by normal people.

When every encounter with a specific substance produces immediate and/or delayed reactions which conform to a repeatable pattern, then that reaction is due to allergy. It is deliberately broad definition emphasis the association of the cause with effect, and depends on clinical observation. Attempts to impose narrow definitions, such as defining ‘allergy’ to IgE-mediated reactions, are too restrictive and do not recognize comparative ignorance of the mechanisms involved.

Any foreign substance, unusually but not always a protein or a combination of a small secule with aprotein (hapten), may act as an allergen which reaches the sensitized an or system by the final common pathway of the blood and extracellular fluids, thus posing every cell in the body allergen. When the specific allergen reaches the specifically sensitized piece

of tissue a reaction takes place with the liberation of clinical mediators which trigger muscle spasm and local inflammatory changes, producing symptoms according to the functions of the effected tissue. Sensitised brionchi produce spasma and sensitized skin eczema, for example, but the allergen may be absorbed without local reaction and pass to a distant sensitized site, the best example being the personal nephritic syndrome due to grass pollen.

INVESTIGATION OF ALLERGY AND INTOLERCE : In the investigation of any allergic or expected allergic situation the neglected art of taking a clinical history is of importance because it is essential to recognize a demonstrable and repeatable use/effect relationship. If such a history can be firmly established, this is better confidence than can be obtained from laboratory or skin tests. All laboratory tests or an ancillary to clinical assessment, and I would comment that the modern tendency to hard results from the laboratory as holy writ without discrimination is to be precated. In fact, it is possible to practice good clinical allergy without forming any immunological tests at all.

History taking may be time-consuming and difficult, but it is well worthwhile when defence pointing to a removable or avoidable cause can be obtained. Guidelines to tory taking are given in tables I to IV , which also outline the key questions which would be asked and how to interpret the replies. Patients will often have observed a out deal about their problems, but this information is a meaningless jumble unless it sorted out in an orderly fashion. In my view it is essential to use leading questions to avoid being bogging down and confused. When patients find that some questions fit their own observations they begin to react positively and helpfully, and then offer significant and usefulk observations. It is most important for the miner to appear interested and to be ready to ask supplementary questions as they occur. This ensures the future co-operation of the patients, who will be now have decided that you are in their side and seriously trying to make some sense out of their problems.

It is very important to question the patient in logical sequence, otherwise vital information will be missed. My custom is firstly to ask about major illness, and then enquire about the family history, with particular reference to asthma, hay fever, polypsia and eczema, and then few questions about conditions which are only sometimes related to allergy such as colitis, crohn’s disease, arthritis and migraine, and behaviour problems in children. A

unilateral family history suggests that the problem may be allergic, but a bilatyeral history makes this much more probable.

The next enquiry, even in elderly patients, should be regarding infant feeding difficulties which clear up never to return or are replaced by infantile eczema, which may or may not perist or change into asthma. It is surprising how much information can be obtained in this way.

At this point, particularly with respiratory problems, it is necessary to separate seasonal from perennial, unless the case is a combination of both. Perennial problems encompass a much wider range of possibilities, and the questions regarding observed differences between symptoms at home, at work or on holiday can give valuable clues and establish characteristics patterns. The tables of questions given here should help to pin down causative factors. In questioning an asthmatic the questions regarding cough are absolutely essential, especially because patients seldom realize how important it is to observe sputum and its consistency.

Many other possibilities, sometime bizarre, may be suggested by patients as a resu;lt of real or fancied observations. I think it is unwise to dismiss these notions without adequate enquiry, but essential to cultivate objectivity in the patient and to insist that they demonstrate repeatability of such reactions on two or preferably three occasions.

FAMILY HISTORY : Some surveys have reported that with a bilateral history the incidence of allergic disease is 50-70% and when unilateral 25%. Although there is a tendency to inherit the same type of allergic syndromes, such as asthma or hay fever, this is by no means an invariable rule. Also, the question of just what is classed as allergic disease and what is not is difficult and controversial.

Various allergic problems may be caused in different generations, usually due to different allergens. Milk allergy or intolerance is a remarkable exception as it clearly runs in families but may produce different allergic syndromes in members of the same family. Thus, removing milk from the whole family diet can benefit more than one member of that family and be dramatically successful.

Allergic disease can develop at any time of life and I have frequently been consulted by the parents or even the grandparents of children I have already been looking after for years because their elders haves now developed allergic disorder for the first time.

The main importance of the family history is to support the concept that the symptoms may be allergic in causation, especially when the syndrome being investigates is one of the less common ones such as arthritis or a gut problem. When enquiries are made from relatives, interesting information often comes to light, so it is really essential to find out everything you can about the family history.

TABLE 1 - - Key questions for all allergy problems

Question Significance of reply Is there a family history of positive history, especially of of allergic disease? respiratory and skin allergy, (Inquiry should embrace a increase the probability of fairly wide range of the problem being an allergic allergic disease, particularly one, particularly if on both asthma, eczema, hay fever, sides of the familyurticaria, angio-oedema, nasal polyps,perennial rhinitis, migraine, and also gut problems such as ulcerative colitis)

Many problems with infant feeding? Affirmative answers suggests

(should always be asked no possibility of a background milkmatter what age ) allergy. Should lead to supplementary questions about pyloric stenosis, pylorospasm, diarrhea, malabsorption, failure to thrive, eczema etc.

There symptoms in summer only? If a clear ‘yes’ ignore perennial or environmental aspects and foods Go to seasonal aspects as laid out in

tables III and IV

There symptoms perennial but Affirmative suggests that this

is a also worse in summer?

complicated multifactorial problem There symptoms the same all

If a clear ‘yes’ follow the schemethe year round?

laid out for perennial allergy

investigations (table II)

What was the age of onset This is an important question

because

of the first allergic the earlier the allergic

problems problem?

begin the more severe they tend to

be and the less likely is spontaneous

remission

Do you have nasal catarrh? Allergic rhinitis, Eustachian

polyps? Sinusitis? Noises dysfunction and polyps may

be missed in the ears? Deafness?

if not asked for and looked for. Loss of can you smell and taste?

taste and smell is common

TABLE II - - Key questions for perennial allergic problems

Question Possible interpretation

Are you worse in winter? Extra bedding (feather quilt),

ducted air heat (dust on the move),

Aspergillus in damp cellars,

mouldy basements

At week – end? Working wives have more

contact

with house dust mites or pets

at weekend. Husbands drink more beer

at weekends

On raising? House dust or other bed

allergens

At home? Envoronmental factors

Inside? Environmental factors,

usually dust

mites or pets

At night? Bed allergens, dust mites,

pets, bed-time

drinks, sex

On holiday? Eiderdowns, bedding and

caravans,

cottages may cause problems, more

wine or change of diet, other

animals, seasonal factors

At work during the week? Occupational factors of all

kinds,

old dusty offices

Visiting relatives and so on? Usually pets or very dusty

house

Outside in summer? Seasonal factors

Are you better

At work? Adverse home environment

At home? Adverse work environment

Outside nor working in Dust or pets and so on,

seasonal air conditioning?

factors also better in air conditioning

On week- ends away? Home environment- - dust

mites,

pets and so/on

On holiday in Britain? Suggests dust or pets at

home

On holiday abroad? Improvement in dry warm

Mediterranean

climates, or at high altitudes in

central Europe, suggests

environmental or occupational factors

at home, particularly if relapse on

return home is swift. Change in food

may also cause improvement.

TABLE III – Questions for seasonal allergic problems

Question Possible interpretation

Worse

Easters or before Local tree pollens, especially

birch,

Hazel ash, plain, mainly London in May

Hot, fry, windy. In the country near Grass pollens can only become

airborne

when ripe and dry (June/July)

Grass cutting, especially pollen stirred up from ground.

Moulds hover mowers

are also disseminated

Warm, humid, during rain, Moulds sporulate when

temperature especially if near deciduous tress

and humidity are optimum

Before rain. Some patients can Moderate rise in humidity

before rainpredict rain accurately

may induced sporulation of yeasts and

moulds

In early hours of morning in Yeasts and basidiospores are

shed by the July and August

million when conditions are right

Year harvesting or combine harvester.Moulds are disseminated in

very largegrain driers

large numbers by these operations

Dry summerpollen count higher in dry

summer

Wet summermould spoes more abundant in

wet

damp summer

Hotter In rain in June/july

Grass pollen is washed down by the rain

In a dry summerMoulds and yeasts are much

less

because humidity needed to sporulate

In a wet summerMoulds and yeasts sporulate

profusely,

and several species may sporulate

on the same day

In frost or snowMould allergies await the

frosrt with

impatience, as the spores will all

disappear from the air. Will also

be well when at winter sports resorts

NOTES : Some seasonal patients sneeze in the pollen season and wheeze in August and September, as the nose is sensitive to one allergen and the bronchi to another. Careful questioning and well-kept patient diaries may be helpful, but the British weather is so fickle and variable that no clear pattern may emerge.

TABLE IV - - A guide to seasonal allergies

March, April and May Tree pollens - - rarely a major

problem.

Knowledge of local tree population

helpful

Late May, June, July - - worse during Grass pollen. Counts rise

earlier in the Wimbledon. Fading out end July

south. The season in spain and the south

of france is May, in the Shetlands,

August/September End July into August

Some times nettle pollen, often peak

for mould spores and so on.

Cladosporium, Sporobolomyces,

Botrytis, Alternaria

Late August into September or even Phoma, Botrytis, basidiospores

(not early October ceasing at first frost

proven). Mould spore peaks very

depending on weather. Skin tests with

moulds are unreliable. Symptoms from

moulds usually occur after the pollen

count has become insignificant.

------------------------- (From the PRACTITIONER, Vol. 231, 8, April 1987; abrideged slightly by Dr. K.S. Srinivasan; for private circulation only.)

HOMOEOPATHY IN ALLERGIC DISEASES

By M. Wiesenauer

In accordance with its therapeutic principles and understanding as specific regulations therapy, homoeopathy treats allergic disease by curing the cause. Consideration of the aetiology and pathogenesis of allergic disease will make this more clear.

In many paragraphs in the Organon Hahnemann has discusses the medicines and their influence on the organism. It will be particularly clear from the summary in paragraph 33 how much unusually high value Hahnemann awrded to the disease—making power of the medicines in comparison to the power of the other disease-making noxious agents. Thereby he speaks of a pathological convertion of the human health. The observation of the medicinal action is within the hypothesis of the medicinal disease and its related preliminary aggravation. It is evident that what we now comprehend as allergic reaction belong to this sphere of observations and operations.

In the past the nature of allergy object was according to practical observation are as manifgestation was comprehended as idiosyncrasy. In para 117 Hahnemann referred to a constitutional disposition and the causative thing (=antigen) which are absolutely essential for causing the idiosyncrasy, but not reacting in the same manner in every organism. The different possibilities of the causative allergens paragraph 207. Hollenberg has therefore rightly given top value for these in treatment an allergic diseases.

In case recording and in grasping the totality this has a special value: In symptoms register with graduations, every symptoms which is predominantly in keeping with the paragraph 153 is accorded the first grade. Foremost with it, is the causative or dietiologis symptom. Braun clearly says that the constant grappling with the manifold environmental influences exposes the temporary immune weakness of the Organism. The causative stimulus may be trivially below normal and only due to the presence of the corresponding disease disposition (“Psora”), disorders occur. The causative stimulus as well the abnormal reactions are absolutely charesteristic in the sense of paragraph 153.

If we find clear aetiologic symptoms we should not then loose sight of it in our search for the medicine.Case 1: A mother with her 10 weeks old infant boy. She complaint that the child has chronic tendency to vomit. This began immediately after birth. The child was kept under observation for a week.

The clinical examination could not reveal anything: all normal for its age. When questioned further the mother said that the child did not take the feed sufficiently all. She further observed that if the child was fed with something other than mother’s milk, there was no vomiting and also not so profuse.

This confirmed the suspicion “Intolerance of mother’s milk”. The mother was advised as to how the child was to be nursed further and Aethusa D6, mornings andf evenings a tablet to be given to the infant inits feed.

Within a week the vomiting became lesser and after two weeks of medication there was no more vomiting. Follow-up for 6 months.

Here Aethusa was given because of the aetiology.

ALLERGIC DISPOSITION : In infancy and childhood atopis skin diseases occur which are summarized as constitutional Eczema and Neurodermatitis. The therapeutic problem in this are well-known and homoeopathy therefore becomes a necessity. The broad action of homoeopathy, from pure organ range and histotrophic prescriptions extending to treatment with constitutional medicine and polychrests and thereby the individual treatment, exemplifies per se the different action points of the homoeopathic remedy. In this homoeopathy can be instituted as prophylactic remedy. Such a prophylaxis-right in allergic disposition of the parents-has developed by Vannier with his work on “Eugenic treatment” as pre-natal treatment. As is well-known, a systhematic treatment during the early period of pregnancy, with high potency (Tuberculin, Luesin, Sulphur) and tehn high potency Calcium derivate is to be carried through. Neurodermatitis and Asthama of the parents, Milk-crust of the parents which are more likely to be inherited by the children can be averted by the eugenic treatment. It is of course difficult to statistically state as to how much foetal development was effected without the eugenic treatment.

CALCIUM AND ITS DERIVATIVES :

The knowledge about the exudative diathesis of the Lymphatic and scrofulous makes it clear as so how we can begin to treat the skin diseases of the children within the first seven years of their life, with Calcium. Purely suppurative processes which develop primarily as such are treated with hepar sulphuris, whereas all the bland chronic, constitutional skin ailments of childhood can be treated by Calcium carbonicum as initial therapy in possible high potency . Only so can we prepare the groun for a further rational treatment.

In later years also in the treatment of constitutional diseases Calcium carbonicum should not be ignored although in principle it is a medicine for early childhood and later we can replace it with Magnesium or Barium.

Such an individualized therapy with constitutional medicine along with intermitting application of nosodes helps an effective influence on the Atopic after which in case of suppression-syndrome Sulphur may be employed.

FUNCTIONAL REMEDY : It has also been repeatedly proved in practice that at the same time we must employ functional and histotrophic medicines. Some new medicines poved as valuable in the aetiology and organ affinity in allergic skin and mucous membrane diseases may be discussed here. These are from the botanical medicine researches made by Willmar Schwabe who has also initiated therapy experiments.

CARDIOSPERMUM: Cardiospermum halicacabum is a creeper plant found in tropicalcountries considered as weed in some places. In its habitat it is considered as non-piosonous although occasionally it causes allergic reaction in sensitive persons. It was also observed from the first trail itself on patients that not only allergic reactions in skin and mucous membranes were observed more often but that at the same time the prevailing rheumatic symptoms also were relieved. This additional effect was obtained by use of deep potencies whereas in skin diseases D3 and D4 were used. In the trails the remedy was used in different potencies, later by injections and then the effects during prolonged interval were observed; the symptoms were reproduced when the medicine was given again.

Cardiospermum is indicated, besides in rheumatic diseases in skin diseases. Schwabe points to cases in which a corticosteroid has been used for

months and upto a year without relief but which became definitely better from cardiospermum.

Further experience with cardiospermum as topical application have been mentioned (cardiospermum salve). Favourable indications are in inflammatory dermatosis, accopained by itching. This form of application of cardiospermum has been found of value in two pharmacological studies in clinical and ambulant so much so that it compares with a cortison-like preparation.

GALPHIMIA GLAUCA : Whereas Cardiospermum halicacabum is suitable in histotropic skin diseases with allergic aetiology, Galphimia glauca is useful in diseases of skin and mucous membranes of allergic genesis.

Galphimia glauca (synonym: Thryallis glauca) belongs to a small and unknown plant family. In the middle and south America and other tropical countries it is known as an ornamental plant only. Willmar Schwabe came to know Galphimia while on a botanical excursion; otherwise there is no hint at all in any literature about its use.

Indication for Galphimia on basis of experience at sickbed are given:

Case 2: 10 years old boy continuously suffering from severe hayfever every early summer in the flowering season although he avoided the flowering meadows. Particularly difficult now during the school days especially since the anti-allergic drugs made him very tired.

The child was given therefore Galphimia D4, 5 drops every 3 hours.

A couple of days later came the report that the drops relieved the hay fever promptly and feeling of tiredness also was not anymore felt.

In the succeeding year the boy got as prophylaxis Galphimia D6, 5 drops in evenings the month before the flowering period. The effect of Galphimia was clear, since he suffered his usual hayfever only to a minimum although the “hay weather” was prevalent; Further doses of Galphimia D4 (4 * 5 drops daily) made a total cure.

Critical observations over a period have revealed that patients treated with Galphimia improved year by year needing less and less medicine and developed hyposensitivity to pollinosis.

This also indicates that Galphimia may be used as in asthmatoid bronchitis and in allergic bronchial asthma.

Both cardiospermum and Galphimia are similar in skin affinity. In 1980 there was a double-blind trial of Galphimia in hayfever syndrome. Example :

Case 3 : 17 years girl, not hyposensitized. Galphimia D4 6 * 10 gtt. The patient suffered from neuroderm also. Upto the middle of the trial period (15 days) while the hay fever was better the skin condition became worse; during the end of the trail (30 days) both faded away although heavy pollen dust persisted during the east wind and sunny days.

Herz has also observed similar results in a serious of Neurodermatitis patients.

The individual symptoms useful for prescription in accordance with para 153 could ascertained if a “proving” is made.

LUFFA : Willmar Schwabe learned from one of his botanical tours of South America about Luffa and its use by the natives in nasal and sinus inflammations.

Therapeutic use of Luffa has been confirmed in many cases of allergic aetiology and allergic genesis. Luffa may be used in high potency in moist catarrh and in low potencies in hay, irritative conditions of the mucous membranes. [From the ALLGEMEINE HOMOOPATHISCHE ZEITUNG , Band 230, No.4, 1985; Translated from the German by Dr. K.S. Srinivasan, Madras; for private circulation only).

ARSENICUM ALBUM IN LICHEN RUBER PLANUS

By Dr. H. V. Muller

A 61 years old lean woman came for treatment of a skin eruption. She has been suffering from this since 6 months. She wanted to be treated only by homoeopathy and was therefore referred to me by a colleague. It was a case of Lichen rubber planus of elbow.

My colleague had taken the case in full and has rightly given predominance to the mental symptoms. As the patient suffered all her complaints from emotional excitement he considered the rubric “Emotional excitement, ailments from” (Kent, p.40), then” palpitation from excitement” (Kent , p.875) and

lastly “exophthalmus” (Kent, p.240) as characteristic symptoms. On these and other symptoms he treated her with Aurum, Natrum muriaticum and phosphorus. This was not successful. The peculiar symptoms like the blue-red colour of the small nodules and particularly the shining and glittering transparent fish-scales like were not found anywhere in the KENT either under “skin eruptions” or “Eruptions on elbows”.

I did not know how to proceed now. The appearance of the eruption pointed to the diagnosis as Lichen rubber planus. But the diagnosis also was of no use since it was not found in KENT.

I referred next to KNERR and succeeded. I found the rubric “Eruption, lichen” with the sub-rubric “exudative rubber” wherein 8 remedies were given-namely, Apis, Arsenicum, chininum arsenicosum, Iodum, Kali arsenicosum, Phosphorous, Sarsaparilla and Sulphur.

As I found a mapped tongue in the patient (Kent p.407) and also as the patients type and constitution suggested, I chose Arsenicum as the suitable medicine.

Arsenicum C 200 was given as intravenous injection and 4 weeks later the skin eruption began to fade and finally totally cured.

(“Ed. Note : As differential diagnosis Neurodermatitis may be suggested. However the clinical diagnosis had only a prognostic valve. For choice of medicine, only the symptoms are guides, as in this case.” – Necessary additions may be in the Kent Repertory – Dr. K.S. Srinivasan).

(From the ALLGEMEINE HOMOOPATHISCHE ZEITUNG, Band 230, No.4, 1985 translated from the German by Dr. K.S. Srinivasan, madras; for private circulation only).

------------------

AN INTERESTING CASE OF ANGINAPECTORIS

BY Dr. H.V. Muller

A strong and robust 60 years old patient with rather overweight complained or heart troubles.

The patient is under my treatment for a fairly long time and I know that he too his job as

editor of a well-known journal with too much devotion and extraordinary industry. I know him as a man of quick reaction and precise expression just as the loan of his daily work with its huge monthly earnings demanded of him.

Is it a wonder that he has, since some months, heart complaints, which have by now increased? And his heart complaints mow run thus :

It mostly commences when he sits and works. The pain does not come slowly, but suddenly and with force. In the chestcage laterally on the right of the strernum he has particularly severe pain which compels him to stand up and move around, which however does not ameliorate. These pains were so cramping and crushing that he felt he would be.

He received nitrolingual from a colleague who suffered similarly. In the meanwhile he purchased some nitrolingual. He took at short intervals two squirts from the sprayer and upto 5 times until the attack was got over.

On days when he got these attacks he mostly woke up with headaches and could not concentrate on his work then.

A reference to Kent was not helpful since it covered heart ailments poorly. Quickly I found in Knerr the following indication:

Heart pain constant in lower part : Lyssinum

Dull, all day, with pinching about fourth rib, right side : Lyssinum.

Not only the heart symptoms agreed with the drug picture but also the mental symptoms according to Mezger :

“Mostly the mental functions are in a state of increased excitement, which manifest quick conception, astoundingly sharp understanding and fast replies to questions.”

The picture became further clear when he answered to my further questions which itched Lyssinum :

He could not tolerate sun-heat. The sound of running water caused him urging to imaginate.

Therapy and progress : After an i.v. Injection of Lyssinum (Hydrophobinum) C 200 the patient did not any more suffer heart ailments.

[From the ALLGEMEINE HOMOOPATHISCHE ZEITUNG, Band 227, No.5, 1982, translated from the German by Dr. K.S. Srinivasan, Madras; for private circulation only].

ROUTINE TREATMENT OF MEASLES?

by M. Freiherr V. Ungern-Strenberg

Early May 1984 a very anxious and worried grandmother consulted me whether I could do anything to her grandchild who now, after the disappearance of her measles eruption, as a sudden attack of convulsions. Now he is in hospital with continuous convulsions and the doctors were battling to save him. I knew the lady since 18 years and had helped her often and knew the child’s father also who died under tragic circumstances. He had an epileptic fit and fell on a saw. The child has suffered during the formative years. The grandmother said that the daughter-in-law did not, for a whole year, make any contact with others. The measles was treated with the usual fever remedies and cough syrups since the modern medicine did not have anything else against viral diseases. Because of this helplessness and the above mentioned complications and diseases as consequence, vaccination is being propagated. The suppressed skin eruption and fever convulsions indicated cuprum which was prescribed in the C 200 potency. The grandmother gave it to the boy on the next day without his knowing it and the child recovered. It cannot, of course, be proved that this single dose brought about the cure of this child given up as lost.

Complications and sequelae : The question has been in my mind as to how closely the much-feared complications, particularly the measles Encephalitis, Otitis, Pneumonias, Noma and so on and not to forget the pulmonal sequelae, pertussis and Tuberculosis all belong originally to the measles – and how much the suppression of symptoms could cause. In the 25 years of my own experience with homoeopathic treatment except two cases of mumps after measles, I never had any case of complication or sequel diseases, no eye complaints and no heart involvements. And my mother too had none in her 56 years of practice, our other homoeopathic doctors also similarly none.

Dr. Hauptmann, Paediatrician who was interviewed by me he had observed among his 300

cases only one measles Pneumonia and one Otitis. These complications are well handled by homoeopathy. It must be evident that the homoeopathically chosen remedy enables the organism to conquer a disease by a medically induced art cure similar to nature’s cure.

Observing physicians have averred about mothers who have spontaneously reprted about children who have made developmental leaps everytime the disease had been conquered – as if a blocked stove has been cleaned. I know cases of perpetual tendency to suffer from repeated infections get over it after they at last come into homoeopathic treatment and the measles for which they had been vaccinated, is produced. Tendency to infections, colds which are taken from where and how they do not know, as a leading symptom for tuberculin. Not only the pulmonary complications, but especially the much-fearred sequel Tuberculosis make us think of diathesis disposition. Measles and tuberclosis terrain – this hypothesis is strongly held in theory. It has been observed that measles excites chronic inflammatory processes in lymphatic regions.

Recent observation have shown the connection of polysclerosis with measles encephalitis which follows vaccination. H.C. Muller has brought about remission of multiple sclerosis with high potency Morbillinum. Another preparation found useful by him in this was the nosode Distemperinum – in the anamnesis question has to be asked regarding association with dogs.

Homoeopathic evidences : What does the Master Hahnemann say? The paragraphs 38 , 40, 46,70 and 73 of the Organon are particularly relevant here.

While Hahnemann speaks of two dissililar diseases in the earlier paragraphs, he been speaks of the so-called fixed diseases which are flare-ups of latent psora; they may also occur partly as epidemics or partly sporadically from psychic or physical upsets.

It is therefore eminently essential to give in acute diseases the homoeopathic angle remedy not only to meet the tip of the ice-berg but at the same time to deal with the diathesis thus minimizing future difficulties. It is a fact borne out by my experience at an individual who displays a definite affinity to a particular medicine holds that affinity for a very long time in certain circumstances.

What is homoeopathy’s view of measles ? The homoeopathic medicines may be found in rubric ‘eruption, measles’ in Kent; we must add to this Tub. according to H.C alen. The choice of the remedy is on the type of fever, the time modalities and the patient’s reaction to warmth, rest, touch constriction, noise, smell etc., thirst, desires,aversions and especially peculiar symptoms of mind.

On the first day of measles mostly no eruption is seen until fever sets in and then on. or bell. is given C 200 occasionaly and after a day or two sulphur may be enquired as complementary. In my opinion, a child afflicted by measles and in whom the plick’c spots are not seen still, is observed to be “weepy”. In addition if firstlessness in fever is also observed a dose of puls. C200 or M is sufficient to overcome the diseases in a few days. In a serios of cases the children had typical swollen face and all symptoms pointed to measles and they had, however, much thirst for cold water, a bottle of water was at the bed-side and a half-empty glass. During the dry, racking cough, they rather sat up than lying down. Here I gavephos. C 200 and a puls. with the mothers with appropriate instructions.

In one case of a 12 year old girl who 3 weeks after one dose phos. given for fear of my school, had measles finally. Here I provoked the exanthema to break out through dose of sul. C 200 and then when much thirst appeared phos. LM 6 and on the third day pusatilla was called for and after 4 days the measles was cured. If the children do not any more feel unwell then I have no anxiety.

Most of the cases of measles I had this spring needed this remedy so that it may be almost called a routine treatment. Nothing of the kind, however, I had Spongia, Antart and other cases.

Two cases I consider as worth discussing ; they date spring 1984: A 9 year old boy who had got over the trauma of separation of his parents through the loving care of the second wife of his father and who became very much upset every time after staying with his mother, suffered from scarlet fever when his mother became pregnant. In the experiences in scarlet fever deep emotional problems have to be overcome and in this case the coming to terms with the opposition situations. They consulted a Anthroposophical lady doctor. As I was called the child already received for while bell, D 6. The foster mother was very anxious as she was much careful to provide for the child a proper motherly love and care. I prescribed Bell. C 200 by which the scarlet fever passed off in a few days and the measles followed

shortly thereafter for which puls. C 200 was given successfully. Through the week-long fever and Bell D 6 the boy was out and out ill. Who can describe the astonishment of the parents as the stated that the child had grown 6 cm. and increased 600 grams weight! On easter Monday the parents of a one year old child called me. All the three children were suffering from measles but the youngest howled terribly, one cheek was red and other pale, was teething and had had Chamomilla C 6 which did not help. I gave C 30 which I considered appropriate to a one year old child. Evening about 22 hours the parents rang me and I could hear over the telephone the child’s cry and I rush immediately. The two other children had been treated by my partner Dr. G. Behnisciss with Acon, and then sul. This infant was treated with puls. The baby wanted to carried by the mother, continuously wriggling back and forth. The parents feared brad affection since the child was stretching violently. I f the mother put it on the be the child immediately reared itself into opiisthotonos immediately. I gave Bell. c 200 and waited. There was no change in about 20 minutes and now because of the continous howling of the child and the exhaustion of the parents I decided to give Cham. C200 and gave one globule. Ten minutes later the child became calm much to the reli8ef of the child, parents and the physician. The C 30 given in the afternoon had brought relief for only about an hour.

A third important case is from my partner Gotthard Behnisch. A child with Asthma complicated by neurodermatitis was treated by a lady colleague with complex remedy with seeming success; the child immediately got Angina which was treated with Silicea which was followed by exanthema which quickly vanished. As the child then got meningitin the parents called Dr. Behnisch. Bell. 10M was given but then restlessness, stiffness neck and jerking of limb began again. Because of the suppressed skin eruption, Zinc was now prescribed and the child got measles. It was ill about 6 weeks totally, a this spring its eczema of one year’s duration has been cured ; for the first time it has no asthma and a vicarious hay fever also was cured.

We observe that every patient received individual medicine even in a “Fixed disease” like measles and there cannot be, in homoeopathy, a routine treatment even considering the genius epidemicus.

-----------------

(From the KLASSISCHE HOMOEOPATHIC, Band 28, No.6/1984; translated from the German by Dr. K.S. Srinivasan, Madras; for private circulation only. Dr. H.V. Murller’s case multiple sclerosis in which MORBILLINUM and DISTEMPERINUM were used with benefi has been given in our “Qrly. Homoe. DIGEST, Vol. I, No. 2, September, 1984.)

-------------------

ROUTINE TREATMENT OF SCARLATINA?

by Dr. Behnisch

In paragraph 100 of the Organon VI edition Hahnemann speaks of the treatment of the infectious diseases and sporadic diseases; “the epidemics of fixed nature” like pox, measles, Scarlatina etc. are exceptions. For Scarlatina Hahnemann gave, according to his pure Materia Medica, Belladona C 30. Can that substantiate a routine treatment of scarlatina?

Case 1: J.B. a young farm woman and teacher came with her son A.B. from a place about 35 Km. away, on 6.11.1980 for her septic sinusitis which was cured by a single dose of Thuja CM; in May 1981 her corn disappeared. An intestinal influenza and left sided tonsillitis were cured without any medicine.

On 28.7.1981, Sepia C 30 was prescribed for prolapsusuteri. On 24.2.1982 left tonsillitis reappeared which likewise went off without any particular treatment. On 10.6.1982 Hepar Sulph. C 30 was prescribed for reappearance of a left sided suppurative tonsillitis which was cured in 2 days.

During summer she sufferd from prolapsed feeling during menses for which on 27.8.1982 Sepia CM was given with good result .

On 15.11.1982 she telephoned that the tonsils were red since 2 days and in the mean while the righ tonsil had become septic. She herself had taken on the previous day at 1800 hrs Belladona C 30 and at 2000 hrs because of the septic condition and chillness with 39degree temperature , Hepar sul. c 30. Because of painfulness of hair when touched (Kent p.120; binding up the hair, p.137), I waited.

Telephone: Severe pain while swallowing, stitching pains and now the left tonsil much swollen . I ordered a single dose of Lyc. B 300. On 17.11.1982 throat still dark-red right tosil septic, stitching and

pulsating pain in the right half of head and temple and ear, very negligible scarlet exanthema. Wait!

22.11.1982: The scarlatina has completely gone, she felt tired, mild desquamation. Throat is not irritating, tonsils have regained normal size.

Case 2 : At the same time her daughter with right tonsillitis. I immediately took a swab and sent for haemolysing streptococcus and in the meanwhile a dose of Bell. C 200. The daughter Alice tehn had a normal scarlatina with primary tonsillitis, fever, the typical scarlet exanthema for few days and finnaly temperature, desquamation and complete cure. Both the patients had no complications till now of any much feared sequel diseases.

In my experience 80% of the cases terminate in this way. But the mother requie Lycopodium which is given in Kent in 3 grade.

Case 3: Last year (19.5.1983) a mother from neighbourhood rang me : “ My son R.F. has septic right tonsillar inflammation and 39degree c fever”. Instructions: Throat swallow (results after six days= haemolysing streptococcus positive) The child has already cough. He got a single dose of Belladonna C 200. The scarlatina was cured in the usual 7 days period. No sequel diseases.

Case 4: Mrs. Rosemarie F the mother was again seen by me on 16.5.1983; she was well last two years she had been successfully treated with single doses of Nat.m., Tub. Calc. carb.

On 1.6.1983, 12 days after the illness of her son, called me on Saturday afternoon: “Right-sided throat pain, pain in right sinus, 39.6 degree fever”. Prescription A single dose of Belladona C 200. Sunday,:2.6.1982: 40.2degree temperature, without thirst. No symptoms of sinusitis anymore, temperature dropped for 39.4. degree C and going down during the course of the day. Otherwise the severe throat pain not altered. Hence re-examination: left tonsil purulent. Swab positive. Lachesis 200 one dose. Severe pain left throat. Tonsil further septic, light erythema which transformed into a scarlatina exanthema.

10.6.1983 : swab negative. Patient felt well.

Case 5: 12 years old girl came recently with a diagnosis of PCP. Within this short period of life she has been given different penicillins 70 times and thrice suffered scarlatina. During the second infection with haemolysing streptococcus the mother

the child asked the paediatrician: “can one not suffer scarlatina once only during life?” Answer: “The first time the scarlet fever was treated with Penicilin the early!”

Naturally it is much easier to successfully treat an acute scarlatina homoeopathically, rather than complicated and frequently occurring diseases as a result of suppression of an acute exacerbation. Children’s ailments are significant markers the development of the child and its defence mechanism. (see the article of Dr.Ungern-sternberg in this DIGEST)

of course, if we heed to Hahnemann’s tenets we will not become dicpouraged and surrender to the sequel diseases or chronic diseases.

What do we learn by the example cases cited above?

1. Homoeopathy treats and cures according to the paragraphs 153, 164, 211 etc according to indicated symptoms. An exact and complete anamnesis is pre-requisite for finding the remedy and the result.

2. And in a sterotyphically flowing disease condition like scarlatina provoked the haemolysing streptococcus we must anlyse the symptoms to find the apt homoeopathically remedy. In Kent (p.1286) there are about 30 remedies for scarlatina and its sequence diseases.

There are no routine prescriptions in homoeopathic treatment in the narrow sense in any case there is no specific treatment according to disease indications (diagnosis) or by poorly defined disease pictures (“Fixed diseases”)

We must never escape our responsibility to know the individual behind the disease and find the singular cause for the individual’s acute disease. That is, we cannot conclude: Scarlatina = Haemolytic streptococcus = penicillin. (statistics in the USA howed that the treatment of scarlatina of penicillin curtailed the disease duration of course, but increased the risks of sequel diseases. Not treating scarlatina by penicillin is less risky.)

In homoeopathic therapeuics it would be: scarlatina, tonsillitis acuta= Belladonna. That is our experience of course which confirms Hahnemann’s but that is not all.

If we dedicate ourselves to the examination and interrogation of the patient to arrive at the totality of the picture then we can achieve the utmost benefit to the patient and always particularly avoid sequel diseases. The patients are generally already cured by the time the laboratory results come.

I have been practicing homoeopathy since 17 years,5 years in private practice. If the homoeopathic treatment according to Hahnemann’s principles, if the prescription of high potencies in single doses were ineffective, we should be staving since long. Fact says, that we homoeopaths have not grown to meet the rush of patients.

We should not, because of that take it easy and fall into routinism or polyprescriptions! If we treat our patients by the individual remedies according to their disease picture (paragraphs 71-104) in future atleast a few physicians will learn from it to treat on these principles.

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[Frm the KLASSISCHE HOMOOPATHE, Band 28, No.6/1984; translated from Dr.K.S. Srinivasan, Madras; for private circulation only.]