Cases Illustrating Repertory Work.
Case 3. – Boy, age 14; epileptic attacks for three years. First attack followed fright caused by other boys’ make believe to hang him. Attacks increasing in frequency until at this time they occur every two weeks. The following symptoms were given: Attacks begin by running round in circle, the falls down unconscious. Attacks are more frequent in cold dry weather and during new moon. Involuntary urination during the attack. Boy complains of always being cold; wants to keep warm both summer and winter. He is very touchy; everything makes him cry; seems depressed all the time. Appetite either ravenous or wanting. Aversion to all kinds of sweets, of which he was previously very fond.
Under complaint caused by fright we find thirty-six remedies. Of these the following twenty-one have the symptoms in the first and second grade: Aconite, Apis, Argentum nitricum, Art. v., Aurum, Belladonna, Causticum, Coffea, Cuprum, Gelsemium, Gloninum, Hyoscyamus, Ignatia, Lachesis, Lycopodium, Natrum mur., Nux v., Opium, Platina, Pulsatilla, Rhus t.
Sadness and depressed. – Aconite, Argentum nitricum, Aurum, Belladonna, Causticum, Gelsemium, Ignatia, Lachesis, Natrum mur., Platina, Pulsatilla
Worse cold dry weather. – Aconite, Causticum
Aversion to sweets. – Causticum.
We have arrived at the solution of the case by four steps and have used all general symptoms. Now you may ask, why did we start with the rubric complaints caused by fright? First: this is a general symptom and we are working from the generals to particulars. Second: This condition was caused in this boy by fright. This mental shock was so profound that it caused the whole condition of this patient to be changed. It not only produced the epileptic seizure, but affected his desires as well. One of the remedies found under this rubric will be the one which will cover the totality of the case.
The second symptom we will take is another general – sadness and depression. We take this rubric from the fact that it is a mental condition produced by a derangement of the patient’s most internal condition, the mind. Now if we hope to cure this case we must have a remedy which has produced this symptom in the provers, so among our first twenty-one we find eleven with this symptom in the first and second grade.
Another general condition is the modality that attacks are worse in cold dry weather. Among the eleven remedies found in the first two rubrics we find only two which are worse in cold dry weather.
In order to decide which of these two will cover our case we will take the general aversion to sweets. Here we find that Causticum must be the mathematically correct remedy, and turning to our materia medica we find that the pathogenesis of Causticum not only contains the rubrics we have used in our analysis, but the remaining symptoms of our case as well.
Therefore, Causticum is the remedy we will give. Our records show that two doses of this remedy were administered with the following results: The attacks lessened during the first month to one; the second attack, a very slight one, did not follow for seven weeks, and now, after an interval of a year and a half, there has been no sign of a return, so we may safely say the boy is cured.
Case 4. – Mrs. A. S., aet. 28; married four years; menses have always been irregular, but during the first year of married life were more regular but always profuse. The third year married gave birth to a seven-pound child; labor normal, no lacerations. Since labor has never been well; the menses would appear every two weeks; then every five or six weeks, with no regularity. The would be profuse and weakening. Had had curettages and various treatments without relief. The condition of the patient at the time of first prescription was as follows: Menses irregular and profuse; great weakness when walking; the walk from the car to office completely exhausted her. Cannot sleep; what sleep she gets is unrefreshing. No appetite; does not want to think of eating. Craves beer, of which she had never tasted but once, and then it was repulsive. Sweats easily; is in a perspiration most of the time and has to be very careful about getting in a draft, as when she becomes chilly she is nauseated.
Menses irregular and profuse – Apis, Argentum n., Art. v., Benz. ac., Calcarea c., Carbolicum acidum, Causticum, Cimi., Cocc., Conium, Digitalis, Ignatia, Iodium, Ip., Iris., Kreosotum, Lycopodium, Murex, Nux v., Nux moschata, Secale, Sepia, Staphysagria, Sulphur, Tuberc.
Worse from warmth – Argentum nitricum, Calcarea c., Cocc., Conium, Ignatia, Iodium, Ip., Lycopodium, Nux moschata, Sulphur
Extreme weakness from walking – Calcarea c., Cocc., Conium, Iodium, Lycopodium, Nux moschata, Sulphur
Great desire for beer. – Calcarea, Cocc., Sulphur
Nauseated when chilly. – Cocculus.
Just a word of explanation of our selection of rubrics in this case. Why did we start with the symptom, menses irregular and profuse? In the first place, it is a general symptom; then it is the symptom above all others that has proved the change in the patient’s general condition; it we expect to cure this case we must have a remedy that has in its symptomatology this condition. On the other hand, if we took any of the remedies we find in the first and second grades under this rubric we would have a remedy for this local condition that so many and various lines of treatment had been used upon with no results; so not only must we take this symptom, but must take the other symptoms, which make this case of irregular and profuse menses different from every other case of the same condition; in other words, that makes of it an individual case. Therefore, we proceed with the other symptoms.
One word more, about our fourth rubric – great desire of beer. Ordinarily this symptom would be of little vale, but we find a patient that before she was affected with this change of internal conditions did not like beer; in fact, she had never tasted it but once and then it was repulsive to her, but now she is sick; some change in her desires has produced a condition of her economy whereby she has a craving for beer. Now the condition has changed and a symptom which in other cases would be of little or no value deserves a prominent place in our record analysis.
This case also has another interesting peculiarity, in that if the keynote prescribers had been working at it they might have reached a correct solution, for in this case we find that the particular symptom, nauseated when chilly, is found under only one remedy, Cocculus.
Our selection of Cocculus in this case was justified, for the case was cured. The menses became regular and normal; the weakness disappeared; the craving for beer vanished; the excessive perspiration and nausea left, until after four months she was discharged stating that she never felt so well in her life.
There are some cases where we cannot individualize closely enough to work our case down to less than two or three remedies. When this occurs we take the remedy which has the symptoms in the highest grade and if the pathogenesis of the drug justifies we give that. To illustrate, I will give the analysis of a case without the history.
Menses copious and dark. – Ammonium carb., Ammonium muriaticum, Antim crud., Arsenicum a., BELL., Bism., Bovista, Bryonia, Calcarea c., Calcarea p., Carbo a., CHAM., China, Cimic., Cocc., CROC., Cyclamen, Ferrum, Graphites, Ignatia Kali n., Kreosotum, Lachesis, Lilium t., Magnesia carb., Acid nitricum, NUX M., Nux v., Phosphorus ac., PLAT., PULS., Sabin., Secale, Sepia, Sulphur
Worse riding in a wagon. – COCC., Ignatia, Nux moschata, SEPIA, Sulphur
Worse before menses. – Nux moschata, SEPIA, SULPH.
Aversion to milk. – Sepia, Sulphur
Sadness in evening. – SEPIA, Sulphur
Vertigo looking down. – Sepia, SULPH.
Here we find by giving a numerical value of two to those of the first grade and of one to the second grade that we have Sepia having a value of nine and Sulphur a value of eight.
Absolute reliance cannot be place on numerical superiority on points for any one remedy; that is, a remedy not having so many points as another will yet have a better correspondence with the vital features of the symptom picture, and be the curative drug to select. This selection must be made from a final comparison of the drug’s pathogenesis as given in a complete materia medica.
In closing the cases for analysis I wish to conclude with the following case to illustrate two points. 1st. That, as regards our prescription, diagnosis has little or nothing to do. 2d. That if we could all forget our diagnosis while taking our case for a prescription we should all be able to do better work. This case will be given as taken by a young lady who had never studied medicine; in fact, all she knew concerning that subject was that when she or her friends were sick she wanted a homoeopathic remedy to make them well. I have never this case personally, but know she is well from reports that I have received through the mail.