It is not at all easy for junior members to read papers before the Faculty. One is overwhelmed by the feeling that you already know all and more than all that I have to say, and that you have dealt successfully with many more patients and their fears than I have, but it is a subject which has always interested me, so I trust you will be patient with me.
It is a very wide subject, but I have dealt with it from the viewpoint of homoeopathic treatment only. Any branching off into the causes of fears, brings us at once into the realm of psychology, a subject which I fear myself, and as I was asked to speak for only 20 minutes I am sure you will agree with me that it is best left entirely alone, and in any case I am firmly convinced that it is in dealing with patients and their fears that the correctly chosen homoeopathic remedy brings results far happier and more successful than any other form of treatment.
There are failures of course, fear is demoralizing, and we must all have had to deal with a certain type of patient haunted by “fear of disease,” sometimes of some specific disease such as cancer, but many times of just disease in the abstract. Such patients will come again and again each time with a different set of symptoms and quite sure that they have a new disease.
They have been suffering from headaches lately, a neighbour has just died from a stroke and they are quite sure their own blood pressure is high; at the next visit they have been told by someone that a relative has just been found to have cancer of stomach and since they heard the news they have had indigestion and loss of appetite. One examines them, reassures them, prescribes for them, only to have them return a few weeks later with a fear that they are going to be crippled with arthritis.
Such patient usually crave for sympathy and usually fasten on anyone they meet to pour out their troubles, they are a misery to themselves, their families, and their friends, and a heartbreak to their doctor, and I must admit that I usually find such patients incurable, although probably you do not. Sometimes there will be some measure of improvement and relief, but usually only temporary.
Fortunately all patients with fear of disease or other fears do not reach this state before they come for advice and treatment, nor are they necessarily the temperament that will over develop such a picture, yet however well a patient may combat his fears, a time of stress, or crisis, a long period of over-work or an illness may weaken his powers of resistance and the fears will get the upper hand and he will need help, and it is here that the constitutional homoeopathic remedy will restore physical health and mental balance, and the fears come under control and in some cases may be removed.
In practice the most common fears which seem to haunt mankind at this time are the fear of disease which I have already mentioned, and a general state of anxiety, of impending evil, a state of affairs which drives some patients nearly to despair and yet they cannot pin down their fear to any one thing. There are other fears of more definite things and I shall mention some of them later, but on looking out a few cases to illustrate this paper Phosphorus was the most frequently used remedy, and three cases were chosen, each of which illustrate a different group of Phosphorus fears.
Checking through the Phosphorus mental symptoms in Herrings Guiding Symptoms the following are amongst those listed.
1. Anxious, filled with gloomy forebodings, as if about to die.
2. Anxious about the termination of his illness.
3. Restless at twilight, when alone, during thunderstorms.
4. Fear and dread in the evenings, of death, of something creeping out of every corner.
5. Uneasy about health.
Mrs. B., age 66, when she first came to see me in 1909. Complaining of heart pain and breathlessness, and acute rheumatic pains in the knees. She had been told that she must be a “sofa invalid” for the rest of her life, but was a great walker and a great gardener and refused to accept such a status without further advice.
Her history was rather vague and indefinite and at the end of the interview suddenly asked if she was frightened of thunder, she replied with a look of amazement, “Why did you ask me that, Im terrified and still go under the table unless I have company”. A review of her history then showed < wind particularly cold wind, and a marked aversion to salt which confirmed Phosphorus as the remedy. Phosphorus 200 iv doses night and morning.
Her first report was that she was better than at any time during the previous 3 or 4 years. Progress was steadily maintained and she resumed her gardening and her walking.
During the past 11 years she has had Phosphorus in different potencies at varying intervals and for various complaints, always with benefit, and now at 76 she is living alone in a cottage in the Cotswolds, looking after her house and her garden and she does not now go under the table in a thunderstorm.
Mrs. E. age 34. Suffering from epilepsy.
This patient had received some benefit from Lycopodium and Sulphur, but at a recent consultation related some new symptoms which she said had not liked to mention earlier.
The fits always occur as she is falling asleep, never at any other time, and there is always a deviation of the eyes to the right. She herself is only aware that she has had a fit because she feels so ill the following day. In number they average 3-4 per month. Until recently she has felt perfectly well between the fits, and these were her new symptoms:
(a) that this winter she has developed an unreasonable fear of the dark.
(b) that she was becoming increasingly worried about her health in general and also had a feeling that now she might have a fit at any moment.
(c) that she had a fear of oncoming traffic and that unless she fixed her eyes very carefully on some object she would walk out into the road and under it.
The first two are of course very well-known Phosphorus symptoms and under “fear of approaching vehicles” in Kents Repertory there is Phosphorus in low type. Phosphorus 200 ii was given and the last report is that she is feeling very much better.
Miss N., age 45. Always nervous about disease and germs, frequently washes her hands lest she should become infected, always slightly nervous of the dark, of death, of thunder, recently complained of “nervy feelings”, especially on going out at night, that she did not feel well and could not understand why, and was obviously concerned about herself. Examination revealed no clinical disease and after Phosphorus 200 ii she reported three weeks later that she was feeling perfectly well and worrying no longer.
The drug which runs most closely to Phosphorus in its fear symptoms is Arsenicum album and in Herrings Guiding Symptoms, some of those in black type are as follows:
1. Fear of being left alone.
2. Fear of death.
3. Anxiety and restlessness especially at night.
4. Excessive anxiety.
5. Anxiety driving him out of bed at night.
In contrast in the fear of disease in Phosphorus which is nearly always a personal fear, in many Arsenicum patients the fear and anxiety about his health is often quite as much fear of the effect it will have upon his family, as fear about himself, and the Arsenicum patient is always full of fears about his family and always imagines something dreadful has happened to them if they are late from school or business.
Mrs. R., age 67.
Complaining of a lump in her neck, noticed six weeks previously, fears it is cancer, fears she will die and that there will be no one to look after her husband and son. Always dreadfully nervous, particularly of hospitals, doctors, etc. Voice goes from nervousness.
Has had treatment for high blood pressure for the last 4 years. Headache < since discovery of the lump.
Diarrhoea from anticipation and nervousness.
Loves housework and one of her main worries is that she cannot now keep things as she would like.
On examination the lump was found to be a small lipoma and her blood pressure was 200/100.
On October 4th, 1950 she was given Ars. alb. 6 b. d. for 4 weeks and on November 23rd reported that she was much better, feeling stronger and more normal and was eating well.
The next case is one of Dr. OHanlons and also shows how the right homoeopathic remedy can restore peace of mind and happiness to a patient in a state of misery.
Mrs. C., age 25
This patient nearly dropped her first baby when he was a month old, and this brought on an attack of acute nervousness. She was frightened of being alone and would suddenly come over in a cold sweat and feel she must get away and walk for miles.
Going to the pictures or reading the newspaper frightened her so much that she refused to do either for months, and she had a constant fear that some illness or accident would harm her child.
To combat her fears she was wearing herself out, doing house- work, quite unable to sit still or relax.
Ars. alb. 200 iii was given in February 1950, and by the end of March she was definitely better and had been to the pictures twice with no ill effect, although she still would not read the newspapers. Ars. alb. was repeated and the next report was in November 1950 when she said she had been very much better until 4 weeks before when she had begun to worry about the overcrowding in the house. Again the Arsenicum was repeated and she is now quite well and happy, able to read the newspapers, go to the pictures and be alone without fear.
The next case is particularly interesting to me in view of the remedy “Coffea” and the symptom “Fear of killing her child.”
Kents Repertory under “fear of killing” has Arsenicum alba and Rhus tox. in italics, neither of which seemed to fit her picture at all, and of those in low type Nux vom. and Sulphur were both given with no benefit.
In Herrings Guiding Symptoms there are only a few in the “mentals” section of Coffea but there is one fear “Full of apprehension of terrible things happening”, which did fit the symptom picture of my patient.
Mrs. A., age 35. Complained that her nerves had gone to pieces since the birth of her second child then six months old. The elder child was three years old.
She stated that the least change of routine, even a visitor to tea, (and she normally enjoyed entertaining), or having a meal delayed, or some little irritation by the children, gave her a violent headache, her face went hot and she felt excited and that she must scream and hit and bite.
She stated that she had hit both her husband and little boy during an attack and then broke down and said that she just lived in terror of hitting the child too hard and killing him.
The effort of coming for a consultation had brought on one of her attacks and she was flushed a deep beetroot colour all over her face and neck with dilated pupils and throbbing carotids.
Belladonna and Stramonium were tired with no benefit, as also were Nux vom. and Sulph as mentioned earlier, and then she gave the clue by saying that a happy emotion upset her much more than a sad one, and she was given Coffea 10M vi powders, to take one immediately she felt an attack coming on.
After a month she reported very much better and later sent for some more of “those magic powders”. She is still excitable, and likes to have a supply of powders in case of emergency, but she is very much more stable than she was, and has quite lost the fear of killing her child.
As a contrast to fear of disease and fear of the unknown and fear of killing the next two cases illustrate a “fear of life,” and both present a very similar picture. One an infant school teacher of 25, trusted by her headmistress, liked by her colleagues and excellent at her work, the other a successful business man of 47, and quite suddenly, for no apparent reason and completely without foundation each thought themselves a complete failure.
Each feared the days, dreading wakening up in the morning because they felt they could not face things, they feared to meet their friends, and they felt utterly incapable of performing a days work, though to the observer each completed the day competently and efficiently, and each was quite hopeless of recovery.
Lycopodium and Silica were tried in each case, and carried the school teacher through one had six moths without her having any sick leave. She remained well for a year and then a lovers quarrel precipitated the symptoms worse than before and she had to cease work for a time. Lycopodium and Silica, Sepia and Argentum nitricum were given with no benefit and then she made an unsuccessful attempt at suicide and Aurum was given. She steadily recovered and returned to work and was later married and has now been well as far as I know for the last 18 months.
In the case of the business man Lycopodium and Silica each helped a little and a six weeks holiday in America helped much more, but very quickly after returning he began to slip back and was then given Aurum with very definite benefit. He is not quite fit yet but is carrying on his business with reasonable confidence and cheerfulness.
My next case illustrates the well-known symptom of Opium. “Fright with the fear of the fright remaining”, but I think it is of some interest because of the lapse of approximately 30 years between the fright and the giving of the remedy.
Mrs. K., age 32 when seen in 1943.
History of epileptic fits, starting during the bombing of the 1914-1914 war, with an average of two major and many attacks of petit-mal per year since, and a marked increase in the number of major fits since the bombing in 1940.
She was an obese woman, fair, very nervous and apprehensive, with fear of the dark, easily depressed when she became weepy and was better for sympathy. < weather extremes.
Good appetite, liked everything except pork.
She was given Pulsatilla at intervals with improvement in her general health, but not much change in the fits, in fact she was in constant fear of having a fit with frequent “warnings” as she called them.
In 1947 I had a letter from her, part of which I quote: “I feel that fear of the air raids in the 14-18 war is at the bottom of all my trouble. I remember one night in particular, it was the first time the anti-aircraft guns were in action and no one knew what all the noise was. A bomb was dropped and could be plainly seen from where we lived, and then there were searchlights, mystifying frightening things to me because I did not understand them. I shall never forget that night although I was only 3 or 4 years old.
I grew up a nervous subject, I have never been nervous of the dark as such, but even now hate the dark with a sort of apprehension as something terrifying may happen during the house of darkness and now the fear seems to have become a complex thing, bound up with my emotions, so that they all seem to touch the old fear and bring on the warning of a fit. I have been told that in one of my fits I am always frightened, especially coming round.”
That is the end of the quotation and you will realize what a state of mind she was in, and as a result of that letter she was given Opium 10M, after which she had no fits for 18/12 and stated that she felt quite changed and released from her fear and in May 1948 stated that she felt wonderfully well. She had several fits again in 1849 Spring, which were brought on by the death of her little adopted child, but again was given Opium 200 followed by 10M one month later and she reported that she felt much better.
I am sure you will be glad that my next case is the last. The patient is full of fears and alas has had many remedies. She has been helped in the past many times, but each time has had a relapse.
The main fear is a fear of sleeplessness. The patient Miss M., age 67, did secretarial work until a year ago, with a few short breakdowns.
She was a very nervous and highly strung child and her first horror of sleeplessness was caused by being made to sleep alone on an inside balcony while at boarding school, as a punishment for talking in the dormitory. She stated that the balcony was under a large dome and close beside the main staircase which led down to the front door. She spent two nights of sleepless terror and since then has never been able to spend a night away from one home without spending each night in a similar condition. When she was younger she could endure it for two or three nights and would go away for weekends, but for years now she has never been away from home for a night.
She is afraid of the dark, afraid of being alone, terrified of becoming insane, and unfortunately visited her mother for six years in an asylum as she became insane following shock from burns, and another sister also died insane.
During the bad nights she is unable to stay in bed and paces up and down the room. She is really in very great distress and if the attacks last more than a few nights she feels really ill.
She has been my patient for 10 years, and in the early days Arsenicum and Sulphur would always end an attack and restore her to normal sleeping, but lately the attacks have been longer, and in her present attack all remedies have so far failed. She has had Opium, Phosphorus, Pulsatilla, Ignatia and Stramonium, all with no benefit.
These are only a few cases out of many, but they are enough to prove the efficacy of Homoeopathy in what is one of the most distressing conditions that patients can suffer.
Dr. FOUBISTER thanked Dr. Priestman for her paper on a subject of much practical importance in prescribing. He recalled a case of Dr. Tylers, a case of exophthalmic goitre which came on after a fright. The patient had been pinned down by a beam of wood in a house which had been bombed and set on fire during a Zeppelin raid in the first world war.
This woman experienced fear long afterwards when the frightening incident was recalled. “Fear, when fear of the fright remains,” led to the prescription of Opium, which cured. Another less dramatic case was that of a boy of seven, who had enuresis from the age of three-and-a-half, years. He had been dry from the second year until the age of three-and-a-half, when he had his tonsils removed, and came out of hospital in a frightened state of mind. There was very little else on which to prescribe, and Opium 200 was given, with a completely satisfactory result.
An usual kind of fear was experienced by a window cleaner who had fallen from a height and fractured both os calci. While in hospital he had nightmares, dreaming of the accident every night. His appearance and the persistent dreams of falling suggested Belladonna, which was given in the 10th potency. The dreams promptly ceased.