Minutus

Dear Rosemary, here are my thoughts regarding your case.

Crotalus horridus - timber rattlesnake, is now a threatened species and is
protected in Minnesota. Loves the sunny open areas of forests, hibernates
communally and becomes nocturnal in the hot summer months. Rarely
aggressive, in fact often timid, unlike other rattle snakes.

This is the sociable snake - somewhere between PHOSPHOROUS and NUX VOMICA.

Lets do a triangle of Rx...

PHOSPHOROUS
NUX VOMICA

Sociable
Ambitious
Exaggerated idea of own importance Has to be
active
Excitable, easily angered
Nervous and excitable
Anxious
Angry and impatient
Timid and irresolute
Self willed
< slight causes
< loss of ambition
Wants sympathy
Reproaches others
Haemorrhagic
Digestive
Hearts
Liver
Degenerative changes in retinal cells
Exudation of blood from eyes
Nephritis
Swollen prostate
Craves acids, salt and spice
Craves piquant foods and stimulants
Dreams of fire
Nightmares - dreams of being pursued
CROTULUS horridus

from the above you can imagine some contradictory symptoms

dullness & ecstasy
sympathetic & suspicious
easily angered& easily moved to tears
compliant & dictatorial
timid & at odds with family
hearts & livers
haemorraghes & malignancy
absorbs intra-ocular haemorrhage
prostate cancer
horrible dreams
delusion pursued by enemies
It is the NUX VOMICA aspect of this remedy which interests me. The
upbringing of Nux. Vom is usually in a strict environment. High standards
are expected. Very competitive and perfectionists, they work very hard and
often resort to stimulants to keep them going. They need to be busy. They
become self assured, confident. They don't need people but neither do they
have a desire to be loners. When these expectations fall apart the anger and
intolerance sets in. They can even become violent. efficiency and perfection
motivates them. Can become obsessive and compulsive. They are good
organisers which can turn into workaholicism. Great attention to detail.
Posture is rigid, stern and aloof. Intelligent and resolute.

Lots of gastric conditions and dependency on stimulants which <<< the
gastric complaints - peptic ulcers are often the result. I can see Cabbage
being a problem and also understand his desire for Mustard. When the liver
finally gives up to these harmful stimulants the body begins to bleed from
every orifice. NUX VOM. is in bold type for oozing blood from the eyes and
vanishing sight. Affects the nervous system = lots of spasms and twitchings.
Nightmares are prevalent - dreams of being pursued. Wakes 3am. VERY CHILLY.

Until we know how this person is doing with his Rx of Crotalus horridus I
would feel confident that it is the correct remedy, but I have shown my
interest In Nux Vom.. I have only 2 questions...

1) Would like some insight into why and how the eye degeneration began, i.e.
why would the pathology go to his eyes/vision.
2) You mentioned "his apparent memory losses and sppech lapses have
disappeared" - what was that all about.

Thanks for reading. Joy Lucas
[Non-text portions of this message have been removed]

Dear Rosemary, you raise some very important and interesting points about
your case.
1) correct assessment is vital during the follow-up. we need to be able to
tell whether the rx has done anything, is it working, has it been antidoted
through drugs or other maintaining causes, is it too soon to say, was the
potency correct, what is new to the case, what are the changes if any to the
person's wellbeing etc etc.

In this case we have new Sx (intermittent claudication) and undisclosed Sx
(hacking winter cough). we can check these off with the Rx prescribed. The
client says he is "disgusted" and appears taciturn or stubborn - won't
elaborate. Are these changes to his state or much the same as before. He
also says he "THINKS" his vision is deteriorating. It is so important to
really really check something like this out. If he is in a bad mood he might
not disclose any good changes and considering some aspects of his
personality this isn't unlikely. So is it really getting <<< or not.

You have looked long and hard at the case and the analysis has been
objective and well informed. There is a juggling of remedies - Crot.h; Phos;
Bell; others are also being considered.

2) Rubrics - I would add (or would have chosen) Eye, bleeding, retinal
haemorrhage which gives us Arnica, Belladonna, Crot.h., Glonoine, Ham, Lach,
Merc.c., Phos., Prunus, and Sulphur. I would also be observing the Rx in the
general rubric Eye, bleeding which would add Bothrops and Nux Vomica + quite
a few others. Eye, inflammation, retina (in Kent) adds a few more Rx than
you mentioned. There is also Vision, loss of + vanishing sight.
Generalities, injuries, extravasations + soft parts. Is there a H/O physical
injury?

3) Potency - was it correct? Dose - was it correct? I also would have given
6 or 12 and prescribed TDS. Is he taking other medication that might harm
the Rx, are there any other maintaining causes which might be preventing the
Rx from working?

4) Quality of Symptoms. I am unsure about his continuous desire to travel -
is it travel, or is it in search of warmth and sun, or is it escape from
something, or is it a need to be busy, or uncontrolled restlessness? Can you
clarify. Elaps loves to travel, (not sure that even the cold bloodied snakes
would want too much sun though). How do you feel about the changing moods -
gregarious and charming and suspicious and censorious - are they alternating
or is one his natural state and the other the diseased state.

5) Choice of remedy. I thought Crot.H was an enlightened choice and I still
do to a certain extent. It covers the whole diseased symptom picture even
encompassing his previous prostate cancer. But is it working and if not why
not? BOTHROPS and CROT.C are the other snake remedies coming though. The
closest non-snake remedies are Phosphorous, ARNICA and NUX VOMICA (my
choice). I don't personally see DUBOISINUM - it is restless and has an
affinity to eyes especially hyperaemia of the optic nerve but......????

You sort of hint at the idea of intercurrent prescribing - where the
simillimum is given but for various reasons seems slow or reluctant to act
on some presenting symptoms - so an intercurrent is prescribed. For example
you might have a case which presents with Sx of locomotor ataxia and the Rx
is Causticum. The person feels benefit and increased wellbeing from this but
it doesn't really touch the deeper seated disease. So Causticum is
prescribed high and an intercurrent, e.g. Aragallus is given low. This is
just an example but this does happen and I think it is justified and
sometimes you just have to try things out. I am not sure that we are at this
stage yet but if we were I would be thinking about ARNICA or Hamamelis. In
fact, when you think about it ARNICA might be a good choice here anyway.
RESTLESS and EXCITABLE - DISAGREEABLE TEMPER - QUARRELSOME - HAEMORRHAGIC
(retinal + anywhere) - DRY SHORT COUGH - TUMOURS - ANXIOUS TERRIBLE DREAMS
etc. THEY CONCEAL THEIR FEELINGS always saying they are well when not.

6) Questions. What do his eyes look like, are there any other Sx with the
eyes - vision, colours, shapes, etc. Can you tell us again if there are any
medications he is taking which is agg. or causing this condition.

From a distance I see Nux Vomica but I am getting interested in Arnica which
might seem poles apart but thats just the downside of long distance case
taking.

I would love to read others ideas.

best wishes, Joy Lucas

Hi Rosemary,

just an additional idea (I didn't follow the entire case description in
toto):

from your description of the patient I would choose the rubric:
MIND; hide, desire to.

Apart from Bell (which you already gave in vain), Stram seems to be very
interesting:
hemorrhage from internal parts, quite a lot of vision disturbances, the
modalities seem to fit, > company;

[snip]

In any case I would use an aqueous solution, LM if possible. Or a 30C in 7-8
tbl.spoons,4-6 succussions, 1 tsp. taken. You can always repeat within a
short time, if necessary.

All the best,

Gaby

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gaby Rottler
Germany
rottler@curantur.de

http://www.curantur.de
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Thank you all for your very helpful thoughts on this case. I've gone back and studied the case as well as the suggestions everyone has made. Lachesis really doesn't fit, although, as everyone has agreed, the snake-like aspects of the case are fascinating. Elaps was an interesting suggestion that I'm still processing. I had been wondering about stramonium because of its relationship with Belladonna. As I studied Stramonium, however, it doesn't fit very well when all aspects of the case are considered. Especially, this case doesn't have the intensity of emotional symptoms that seem to go along with Belladonna. I also gave some thought to crot-c, which I hadn't really considered before seriously. However, this case doesn't have the spooky supernatural delusions that seem to go along with crot-c, and crot-c isn't in the various retinal inflammation rubrics -- its pathology doesn't really affect the eye (although, of course, the heart is involved both with crot-c and with this case). Bothrops just doesn't describe this patient.

As Joy indicated, Nux Vomica superficially looks like a good possibility, and I had analyzed it previously. The mental state could fit well, but the physicals just aren't there.

Many of the "retinal bleeding" rubrics describe hemorrhagic bleeding which comes out through the eye, which is not the case here. The effect in this case is a sort of extravasation of the retina with resulting damage. This aspect also lowers the likelihood of remedies working such as hammamelis, which aids in resporption of leftover blood in the eye. The rubric "eye inflammation retina" is applicable, I think, but not the others that deal with ocular hemorrhages.

TThe loss of vision rubrics are tricky as well, as I've learned. In many instances, they actually address vision problems resulting from muscle diseases or diseases of other parts of the eye, such as cloudy lenses -- facts revealed by reading the definitions, cross-references, and synonyms in Synthesis. Or they refer to various kinds of partial or temporary vision loss. The rubrics "vision, loss" and "blindness" are huge -- not too useful.

I've also researched Arnica more in depth -- and, quite possibly, Eureka.

Vithoulkas' Materia Medica description of Arnica was most helpful, since he specifies that the Arnica state may be brought on by traumas not only to the physical, but equally to the EMOTIONAL, OR MENTAL body. Aha! I've been convinced all along that something having to do with the war experiences he relives in anguish every night was at the root of this whole scenario, as if the blindness is an irrational subconscious attempt to stop seeing over and over again every night in his dreams the bombing raids he carried out during the war, with their consequent destruction and death -- also the terror of flying bombing missions amid searchlights that could allow his plane to be shot down, which it was three times.

Arnica has recurrent vivid dreams of past horrible events, something absolutely key to this case. It also has great restlessness, seeking to avoid pain, and if we look on this whole case as resulting from emotional/ mental pain more than physical pain, this explains the constant traveling -- a restless change of venue, constantly, to find more peace. His traveling is not a seeking after sun, rest, particular new experiences, bragging rights -- things that travel often means to older people. It's not even focused particularly on visiting relatives and friends, although sometimes he does this on his way somewhere and back. It's simply a search for movement, change, stimulation. All his life, he's sought adrenaline rushes from experiencing the unfamiliar, new, challenging, and daring.

Arnica also has a proliferation of superficial friends, but a paucity of deep ones in whom he confides -- doesn't want anyone penetrating or getting close. Yes!! -- Again the emotional level is the one involved.

Arnica is haughty and irritable-- his own authority. Arnica is also subject to delusions that he is well when he isn't. This accounts for this patient's unaccountable cheerfulness when being interviewed, and actually in day to day being with people -- he manages never to let anyone see sickness, sadness, weakness -- keeps up the appearance of strength and self-sufficiency. In fact, this man has had terrible heart disease for decades, yet he's also been a fanatical tennis player until he couldn't see any more -- creating the illusion of the active, apparently perfectly healthy athlete figure even with deep underlying disease that makes physicians cringe. Even in dealing with blindness, he's managing somehow to present a front that appears absolutely unhandicapped -- walking unaided (he does have very limited peripheral vision, and he's fallen quite a few times upon encountering unexpected obstacles, but maintaining that front is all-important to him), and doing everything as you would expect anyone to -- quite an amazing performance, really. He's also, underneath, terrified of what will happen to him, and quite hypochondriacal, seeing a multitude of doctors for a wide variety of minor ills, in addition to his major problems -- but still maintaining stoutly that he's basically fine.

Physically, the spheres of action match Arnica quite well: heart and circulation, clots, bruises, oozing blood, eyes, throat, extremities, prostate inflammation. Arnica desires vinegar. He didn't say he liked this, but the only foods he strongly liked were mustard and pickles (both with strong components of vinegar).

So I thank you all profoundly for helping me to view the case in a new light and re-examine various remedies that I'd examined before and rejected for specific reasons. As it turns out, my reason for rejecting Arnica was an inaccurate assumption, that the cause for an Arnica state was only physical trauma. Vithoulkas' presentation of it was really eye-opening, and I hadn't read it before. So my next approach will be to prescribe Arnica for him.

Now, a question as to potency -- this has bugged me throughout this case. We have here severe pathology. High potencies in severe pathology can be further destructive. So I've stayed with low potencies, aqueous solution, daily plussing (although the low potencies have also adduced the need for waiting a substantial time between evaluations, a situation contrary to the acute feel of the case -- how to resolve this conflict? In general, I've experienced that even in low potency, if a remedy is right, there will be some positive movement relatively soon, even if it's very minor. There's been no evidence of any such result with any remedies in this case, so far.). I feel as if I should continue to keep potency low, because of the pathological aspect of the case. Any insights from others, before I actually prescribe the remedy for the patient?

Many thanks. Rosemary C. Hyde, Ph.D.

Dear Rosemary,

Regarding potency in your case, I can only recall my early training on this. If you want to go in on an emotional level begin higher. If you think this man's vitality is strong and that the case's center is emotional then perhaps a higher potency would be useful. I usually view 200c as a middling potency which works pretty deep, especially if the person's constitution is sensitive.

Thank you for this wonderfully interesting case. Am waiting to see how it fares.

tanya

hi dear rosemary, i am one of those who usually sit on the sidelines, since
i joined this wonderful list, and learning a lot from it. i am not that new
to homeopathy, studying in my fourth year now, but that is not so much when
i consider how long (over 20 years)i have studied in other fields that i
consider myself to be very well versed in, an expert,and psychology is one
of those fields. so, i wanted to comment on something i just read in your
write up. i think his blindness that you describe as coming from an
"irrational subconscious attempt....." is right on target, including the
whole sentence. BUT, i would not consider it irrational at all and i call
the subconscious the unconcscious. i think this is a case of post traumatic
stress syndrome or post traumatic stress disorder as it is called often. we
just did some work in class at teleosis and one of the woman thought two of
the remedies we studied might deal with this. i will be back in touch with
more later. i loved what you said vithoulkas wrote about arnica and
emotional trauams. makes total sense. best wishes, to you and to everyone
for a year filled with many dreams come true and lovingkindness everywhere.
sheila
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