Dear Luis,
Hypothyroid as consequence of autoimmune thyroiditis – early stages – kept euthyroid by thyroid hormones.
Hyperplasia of both adrenal cortexes. – detected much later stage.
Comparatively raised cortisol vis-à-vis ACTH would weaken thymus and thus lower functionality of immune system.
Also lowered levels of POMC which is expressed in the pituitary gland and in the arcuate nucleus of the hypothalamus, can lead to lowered levels of ACTH and Endomorphines.
Assuming that lowered levels of POMC, the precursor to both ACTH and Endomorphines is, or rather, was the root cause:
Endomorphines would be low, stress levels would go up thereby cortisol levels would tend to rise, thus depressing the already low ACTH in the feed back to near extinction.
You could look at these sarcodes in that order:
1. Hypothalamus (hypoth.)
2. Pituitaria anterior (Thyreostimuline?, pitu-a.) (Anterior Lobe of Hypophysis) (David Flores Toledo Mexico 1987 )
3. Pituitaria glandula (Pituitrinum, Entire gland Hypophysis, pituin., pitu-gl.) (P. Sankaran India1965 and 1967)
4. Pituitaria posterior (Posterior Lobe of Hypophysis, pitu., pitu-p.) (Hering United States 1935 )
5. Corticotropinum (ACTH, Adrenocorticotropic hormone, cortico.)
6. Adrenalinum (Epinephrine, C9H13NO3, adren.) (R. Hayes 1922, Dr.V. L. Getman United States 1904)
See extracts below.
Regards.
Sarvadaman Oberoi
H 485 FF Ansals Palam Vihar
Gurgaon 122017 Haryana INDIA
Mobile: +919818768349 Tele: +911244076374
Website:
http://www.freewebs.com/homeopathy249/index.htm
email:
manioberoi@gmail.com
________________________________
From:
minutus@yahoogroups.com [mailto:
minutus@yahoogroups.com] On Behalf Of Irene de Villiers
Sent: Wednesday, May 02, 2007 12:38 AM
To:
minutus@yahoogroups.com
Subject: Re: [Minutus] cushing syndrome?@Irene
Luise Kunkle wrote:
Both these things imply high cortisol produced so that it suppresses
ACTH in the feedback loop - or so I would see it.
For total cotisol 24hr-urine I presume you mean.
I really do not know how to properly interpret this, but my comments:
To me it implies that there is certainly a problem with adrenals - or
there would be no hyperplasia - also you originally described clear
cortisol-caused symptoms which is also a problem in my book - so the
"normal" urine cortisol is odd looking to me.
I'd be inclined to ask "how normal" is it?
Different labs use different guidelines on what's normal - based on a
sampling of the local populatiopn. Well if that is mainly football
stars, they make a lot of cortisol just due to stress exercise and the
"normal" can go up. If a sedentary person then reads the way an
over-excercising athlete reads - that's NOT so normal is it?
There are also different lab tests used on the 24hr-UR test - and some
are not nearly as reliable or consistent as others I have found. For
example here in Spokane there are 3 labs with different tests - only one
gives reliable and consistent readings - and the other two are all over
the place. for example same sample gave a 107 reading and a 149 reading.
I saw one result reported as "20" that was actually 202. (Someone forgot
their 3rd grade artithmetic and forgot to multiply by ten? The result
was "normal" when it should have been ten times normal.)
I'm not saying this happened in your case in point - just that it is
possible to get a lab error and that a normal reading is odd to me in
conjunction with real symptoms and real hyperplasia.
Hopefully an endocrinologist can add more insight:-)
As a homeopath I'd support the system assuming serious adrenal
exhaustion and of course the cushing's symptoms and emotional aspects -
at least until/unless you can accumulate more useful diagnostic
information to use.
On my cushing's list we also see some people with "cyclic" cushings,
where the cortisol is sometimes high and sometimes not - in a cycle.
This DOES cause cushing's symptoms - due to the regular periodic
cortisol overload which does damage before it is dissipated and/or
excreted - but the readings are often "normal" at any random lab test
point. So that's perhaps another option.
EXTRACTS:
The hypothalamus controls almost all secretions of the pituitary. The posterior lobe is controlled by nerve fibers that originate in hypothalamic neurons and the anterior lobe by substances that are transported from the hypothalamus by tiny blood vessels.
The anterior pituitary produces and secretes hormones in response to releasing hormones produced by the hypothalamus. These travel to the anterior lobe by way of a special capillary system, called the hypothalamic-hypophyseal portal system. These hypothalamic signalling hormones include:
1. TRH (thyrotropin-releasing hormone)
2. CRH (corticotropin-releasing hormone)
3. DA (dopamine, "prolactin inhibiting factor"/PIF)
4. GnRH (gonadotropin-releasing hormone)
5. GHRH (growth hormone releasing hormone)
A. The tissues in the anterior lobe of the pituitary consist of extensive vascular areas interspersed among glandular cells that secrete a number of hormones. Each is individually synthesized, probably by a specific type of glandular cell. Three such types of cells exist in the anterior pituitary gland, acidophils, basophils, and chromophobes. The anterior pituitary produces and secretes:
1. The growth hormone, thought to be synthesized by certain acidophils, stimulates all the tissues in the body to grow by effecting protein formation.
2. Adrenocorticotropic hormone (ACTH) controls the secretion of steroid hormones by the adrenal cortex, which affects glucose, protein, and fat metabolism.
3. Thyrotropin (TSH) controls the rate of thyroxine synthesis by the thyroid gland, which is the principal regulator of body metabolic rate.
4. Prolactin, which regulates the formation of milk after the birth of an infant,
5. Three separate gonadotropic hormones, follicle-stimulating hormone, luteinizing hormone, and luteotropic hormone, control the growth and reproductive activity of the gonads.
6. Endorphins (Endomorphines) released alongwith ACTH by their precursor POMC, which is expressed in the pituitary gland and in the arcuate nucleus of the hypothalamus.
B. The two hormones that are produced by the posterior lobe of the pituitary are synthesized by nerve cells in the hypothalamus. They are transported by nerve fibers to nerve endings in the posterior lobe, where they are released. The hormones are antidiuretic hormone (ADH or vasopressin), which alters the permeability of the kidney tubules, permitting more water to be retained by the body; and oxytocin, which aids in the release of milk from mammary glands and causes uterine contractions.
C. The only hormone that is synthesized by the intermediate lobe of the pituitary is the melanocyte-stimulating hormone, which appears to control skin pigmentation.
The better-known neurotransmitters of the central nervous system include the catecholamines (dopamine, epinephrine, and norepinephrine), serotonin, acetylcholine, gamma-amino butyric acid (GABA), histamine, and the opioid peptides (enkephalins, endorphins, dynorphin, neoendorphin, rimorphin, and leumorphin). These substances are distributed widely in the central nervous system and, for most, also in the pituitary gland. If a particular amine or neurotransmitter is present in nerve fibers leading to the median eminence, it probably will influence pituitary gland activity via the portal system. Dopamine, serotonin, gamma-amino butyric acid, and acetylcholine are best known for such activity. These neurotransmitters play an important, but poorly understood, role in regulating pituitary function, either directly or by their action on neuropeptide-producing neurons. Understanding the pharmacology of neurotransmitters holds promise for the treatment of basic disorders of the hypothalamic-pituitary axis.
Complete Repertory, Roger van Zandvoort
Harshness, rough
pitu-a.
MASTER F. J., Perceiving Rubrics of the Mind (mtf20)
K - Kent's Repertory;
P - Phatak's Repertory;
BB - Boenninghausen's Repertory;
Ss - Schroyen's Repertory;
Syn - Synthetic Repertory;
V - Vithoulkas Repertory.
Z - Zandvoort
Housekeeping, women inapt for
Z, Syn, Ss.
Disease Condition:
Depression
Anxiety disorder
Schizophrenia
Mania
Important Drugs: Lyc., Nux-v., Pitu-a., Sil., Sulph.
MURPHY R., Homeopathic Remedy Guide (mp4)
Pituitaria glandula
Pharmacy
Pitu-gl. Pituitaria glandula. Pituitary gland. The mother tincture comes from the organ, prepared by maceration in a mixture of water and alcohol-glycerine from the posterior lobe of the pituitary gland. Historical dose: All potencies, 6c to 30c potency.
History
The posterior hypophysis represents the least important fundamental part of the pituitary gland. Its principal physiological role is fulfilled by the antidiuretic hormone which intervenes at the kidney, where it regulates in part, the tubular reabsorption of water.
The extracts of the posterior lobe of the hypophysis cause, amongst other things, uterine motor reactions, (oxytocic action) and the vaso-constrictive reactions (hypertension) when taken in heavy doses. One oxytocin has been isolated, but vasopressin is nothing more than the anti-diuretic hormone. The Homeopathic proving was established by the Hering Proving Committee in 1935 on five provers, using the potency 12x.
Homeopathic
The pituitary gland exercises a superior control over the growth and development of the sexual organs, stimulates muscular activity and overcomes uterine inertia. Uterine inertia in second stage of labor where os is fully dilated. High blood pressure, chronic nephritis, prostatitis. Ten drops after meals, (George Fuller)
Pituitary is a vaso-constrictor and parturient. It is used chiefly for its action on the uterus either to aid in childbirth or to check bleeding after delivery. Cerebral hemorrhage. It will check hemorrhage and aid absorption of clots.
The action of this remedy has a clear anti-spasmodic tendency, especially affecting the vessels in the head. Vertigo, difficult mental concentration, confusion and fullness deep in frontal region. Nocturnal anxiety. Obsession of ideas, especially the depressive and erotic. Congestive headache.
The action of the homeopathic dilutions affects especially the female gonad glands. Painful menses with disturbed cycle. Bedwetting. Cervical pains. Pigmentation disorders and loss of hair.
Clinical
Amenorrhea. Breast disorders. Colitis. Delayed growth. High blood pressure. Prostatitis. Vertigo. Vitiligo.
Constitutions
Phosphoric, flouric types, tubercular poisoning or syphilitic with obsessions or depressive complaints. Tubercular and syphilitic types benefit particularly from the action of this remedy. Planets: Moon.
Modalities
Better from fresh air. Better in the open air. Worse from the heat. Worse in a closed room. Worse at the end of the day.
Symptoms
Mind
Anxiety, aggravated at nightfall. Obsession ideas linked to the uro-genital area. Fear of impotence, fear of passing urine. Nocturnal anguish. Tormenting thoughts, especially or erotic nature of impotence.
Abdomen
Enterocolitis. Rectocolitis. Spasmodic colon infection. Inflammation of the gallbladder.
Back
Pains in the nape of the neck, spreading to the occiput and thence to the shoulders. Neck ache. Backache.
Breasts
Atrophy of breasts. Amenorrhea with breast atrophy. Breasts hypertrophy.
Chest
Growth of hair on chest.
Ears
Buzzing with no particular modalities. Earache. Deafness in the left ear.
Eyes
Mydriasis: pupils very dilated. Weeping: the patient cries involuntarily and even without noticing. Styes, especially on the left. Conjunctivitis. Blepharitis.
Female
Difficult childbirth. Menses very painful, especially the day before and the day after the start. Dysmenorrhea. Menses scanty. Uterine pains from muscular contraction. Painful uterine contractions during childbirth.
Menses late: cycle longer than 30 days. Menses with pain during the day. Amenorrhea with breast atrophy.
Head
Alopecia of the scalp, which is very dry. Pulsating, throbbing headaches, related to hypertension. Headaches, starting at the occiput and spreading towards the base, cervical column and shoulders. Headaches, aggravated by heat, confined space, at the end of the day. Congestive headache.
Heart
Feeling of heaviness in the precordial region, aggravated by the slightest movement. The patient can 'feel his heart.' Sensation of heart constriction, aggravated by the slightest exertion. Arterial hypertension with the feeling of pounding arteries in the temples and carotid arteries. Arrhythmia. Coronary arthritis. Angina pectoris. Valvular disease. Septicemia. Cardiac neurosis. Tachycardia. Hypertension.
Kidneys
Presence of albumin in the urine. Anuria. Incontinence of urine, worse in the evening. Incontinence when the patient loses a few drops. Incontinence of urine in women with fibromatous uterus: the patient loses a few drops of urine on rising. Urinary incontinence. Nephritis.
Lungs
Asthma. Asthmatic dyspnea, accompanied by intestinal and rectal spasms. Dyspnea with abundant, watery, salty-tasting sputum, sensation of constriction in the thoracic cage. Laryngitis. Tracheitis and bronchitis. Dyspnea from anguish.
Mouth
Excessive salivation. Saliva tastes salty.
Nose
Coryza.
Rectum
Diarrhea with painful intestinal spasms. Rectal tenesmus: the patient wants to pass stools, but cannot. Proctitis. Hemorrhaging recto-colitis.
Skin
Skin cold, discolored or strongly pigmented. Alternating white and dark patches. Vitiligo. Skin is swollen, edematous, itching. Eruptions of a urticaria type. Skin very dry, scaly.
Stomach
Nausea and post-prandial distention, worse after the evening meal.
Throat
Tonsillitis. Pharyngitis.
Compare
(1) Ign. - Cortical and visceral rhythm disorders, characterized by mobility instability and paradoxical, contradictory state of symptoms.
(2) Syph. - Changing moods, forgets proper nouns, obsessions, all aggravated at night.
(3) Thuja - Fixed ideas, sad, varicosities in the nostrils, skin sticky.
Sources
Boericke.
VERMEULEN F., Concordant Materia Medica (vml4)
Pituitaria glandula
Pitu-gl.
Hypophysis posterior
Characteristics
Exercises a superior control over the growth and development of the sexual organs, stimulates muscular activity and overcomes uterine inertia. Its influence over unstriped muscular fibre is marked. Cerebral haemorrhage. Will check haemorrhage and aid absorption of clots. Uterine inertia in second stage of labour where os is fully dilated. High blood pressure, chronic nephritis, prostatitis. Vertigo, difficult mental concentration, confusion and fulness deep in frontal region. Use 30th potency.
VERMEULEN F., Synoptic Materia Medica 2 (vml3)
M – Mind
G – Generals
P- Physical
Eupionum
Eupi.
Sleep
Sleepiness during menses [1; Nux-m.]. Sleeplessness during menses [1; Pitu-a.].
Bacillus morgan-Gaertner (Paterson)
Morg-g.
Generalities
Allergy, metal dermatitis [1; Pitu-a.].
Pituitaria glandula
Pitu-gl.
Signs
Glandula pituitaria. Hypophysis. Master gland.
Unpaired compound gland suspended from the base of the hypothalamus, and consisting of two major subdivisions: the neurohypophysis [posterior lobe] and the adenohypophysis [anterior lobe]. The gland was once thought to produce mucus, hence the name pituitary [pituita = phlegm].
"The pituitary is the gland of many hormones and functions. It controls growth in childhood and adolescence, sexual development and sexual metabolism. It is necessary for proper evolution of the reproductive glands. The post-pituitary regulates the water balance of the body, blood pressure, gastrointestinal tract, and influences the fatty and sugar metabolism. It also determines the pigmentation of the skin. There is more vitamin E found in the pituitary than in any other gland. A deficiency of vitamin B castrates it physiologically and psychologically. It is as important for the pituitary as is vitamin E for the testes and placenta. Normal functioning of the pituitary involves the metabolism of manganese. Manganese foods prevent pituitary strain. These include potatoes, lettuce, agar-agar, wheat germ, liver, peanuts, walnuts and almonds ... The pituitary controls the growth and form of the skeleton. The forces of Taurus-Scorpio lay the foundation of this work, Taurus bearing the celestial pattern and Scorpio [the Lords of Form] reproducing that pattern in material form ... In biblical symbology the pituitary gland is represented variously as, for instance, by Noah's Ark, by the Cherubim hovering above the left side of the Holy of Holies, by the new moon worshipped by the twelve tribes, by the laver of purification in the Temple, and by the blessed Virgin Mary." [Heline]
"Efforts to establish the planetary correspondences to the glands have not proved entirely satisfactory. Each organ containing, as it does, all other organs, results in an unsuspected diffusion of vital principles. For instance, 'the real liver,' writes Paracelsus, 'is to be found in all parts of the body,' and only its head is in that organ which science calls the liver ... The pituitary body shares a similar plethora of correspondences. Since the advent of Uranus into the solar family, this planet has enjoyed a preferential choice as the ruler of this gland. The moon was assigned thereto by the ancients, the 'Hermetic Marriage' being the union of the sun [pineal gland] and the moon [pituitary body] in the brain. Those with a flair for riddles may find it profitable to ponder the adage that the sun rules by day and the moon by night, esp. when it is intimated that the pituitary dominates the phenomenon of sleep ... Each of the glands has several aspects of its function. It is likely that the ductless glands are all septenaries and that modified forms of the activities of all the planets may be discovered in each of the glandular centres." [Hall]
Proved by P. Sankaran in the Bombay Homoeopathic Medical College on two occasions, once in 1965 and again in 1967 by two different sets of provers. The 3x and 30th potencies of the whole gland were used. Nine provers participated in all, two of them were given sac lac as controls.
PECULIARS
M Listless; difficult concentration.
"Reads one line, then rereads it, thinking it to be another line."
Aversion to motion.
G amel. Application of cold water [headache; burning pain in eyes].
But generally agg. cold.
G Thirst for large quantities of cold water at long intervals.
G agg. Evening and towards night.
G Vertigo when not moving body or head; doubly severe on motion, esp. of head.
and Sensation of vomiting, with empty stomach [which he thinks will relieve him].
and Heavy, swollen eyes.
G Fever at night. [In 3 provers]
P Headache; starting as dull and increasing to throbbing.
agg. Evening; sun.
amel. Cold; rest; closing eyes; pressure.
and Heavy, swollen eyes.
P Sinking in stomach at noon.
Preceded by nausea at 11 a.m.
c Compare with Pituitarium anteriorium:
Redness of eyes.
Stuffy nose at night.
Constipation; stool very scanty as if some stool remained behind; stool very sticky, like jelly.
Palpitation at night before sleep agg. lying on left side.
Food
Desire: Cold drinks [1].
Notes
Pituitaria anterior
Pitu-a.
Signs
Adenohypophysis. Anterior lobe of hypophysis.
Consists of cords of cells of several different types interspersed with capillaries. The secretion of somatotropins, prolactin, thyroid-stimulating hormone, gonadotropins, adrenal corticotropin is regulated by releasing and inhibiting factors elaborated by neurons in the hypothalamus.
Pathological symptoms of the anterior lobe of the hypophysis rarely occur in humans. Very occasionally, a swelling or growth may develop which can lead in young patients to giantism and in the elderly to visual disturbances and hormone deficiencies [Simmonds' disease]. These symptoms can occur in women after a complicated confinement with major loss of blood and shock. The pituitary necrosis is then caused by ischemia.
In humans, the middle lobe of the hypophysis is poorly developed. This lobe, which is closely connected to the anterior lobe, produces a hormone whose function is only known for lower vertebrates, i.e. blending with the background colour [chameleon].
In occult physiology, it is believed that the pineal gland and the hypophysis function as the two sentries at the threshold. These two sentries, which stem from ancient esoteric tradition, work closely as catalysts in the process of acquiring spiritual consciousness in the material world. It is said of the hypophysis that its duality is inherent in the duality of the human being. In the posterior lobe, hormones are produced after information has been transferred via nerve fibres [male aspect]. In the anterior lobe, this occurs by means of the blood [female aspect]. It is believed that this duality is not expressed in the pineal gland because the hypophysis has a special link with the material world, and the duality that material evokes brings about the contrast between male and female. The moderately developed middle section is compared to the golden mean, the ability to adapt to circumstances, which is the great talent of the chameleon - a characteristic which is often seen in a negative light.
The homoeopathic drug picture is based upon 5 years of clinical observations by Dr. David Flores Toledo [Mexico], who named the remedy Hypophysinum anterioris. "Hypophysinum anterioris may well become one of the great polychrests, but it needs a careful proving. Numerous cases of acne, obesity, one of sterility, headaches related to menses, asthma, haemorrhoids, breast nodules, fungal infections of the nails, recurrent tonsillitis, vitiligo, and warts have been resolved with this medicine." [Flores Toledo, Journal of the American Institute of Homeopathy, Sept. 1987]
Compare
Natrum muriaticum. Sulphur. Pulsatilla. Calcarea carbonica. Sepia. Kali phosphoricum. Calcarea sulphuricum. Kali sulphuricum.
Region
Mind. Digestion. Female organs. Mucous membranes [nose; throat].
Leading symptoms
M Ailments from disappointed love.
Aversion to everything [friends, husband, herself].
Sexual desire diminished; enjoyment absent.
Yet fear to be alone.
M Irritability BEFORE and during menses.
Desire to strike.
Screaming and crying from anger.
M DISCOURAGED; during menses.
Causeless weeping.
Dislike of oneself.
"Easily depressed and avoids her friends."
"Feels attracted to the subway rails." [Flores Toledo]
G agg. Cold.
Lack of vital heat during menses.
Susceptible to tonsillitis, sinusitis and obstruction to nose.
G Craving for sweets and chocolate.
G Thirst for large quantities.
G agg. BEFORE MENSES.
[fearfulness; irritability; sadness; headache; coryza; pallor of face; nausea; vomiting; distended abdomen; yellow leucorrhoea; pain in ovaries; pain in uterus; difficult respiration; painful swollen breasts; low backache; sleeplessness]
G Vertigo [as if intoxicated].
agg. Entering dark room [from a lighter place].
agg. Before and during menses.
agg. Lying on back; moving head; rising from stooping.
amel. Sitting.
and Perception of colours [pink, red, yellow, green].
P Perspiration on scalp at night.
P Headache [esp. in temples] before or at beginning of menses.
agg. Light; noise; sun; warm room.
and Empty feeling in stomach [without hunger].
and Photophobia.
and Nausea.
Preceded or attended by visual disturbances.
P [Moist] eruptions on [or inflammation of] earlobes from wearing ordinary earrings [no precious metals].
P BROWN SPOTS ON FACE.
P Nausea on looking at or smell of fatty food.
P Nausea amel. eating.
P CONSTIPATION. Every other day. Every two or three days.
Stool DRY, HARD, LARGE [or like sheep dung].
and Irritability.
P Anticipatory DIARRHOEA before a date or engagement.
Diarrhoea from milk and milk products.
Rubrics
Mind
Anger in morning on waking [1]; from contradiction [1]; at trifles, during ovulation [1/1]. Dreams of death of relatives [1]; of dogs [1]; frightful [1]; paralysing [1/1]; of snakes [1]; of war [1]. Hatred [1]. Learning poorly [1]. Desire to weep, but finds it difficult [1/1]; weeping at trifles [1].
Vertigo
With tendency to fall before and during menses [1/1]. With trembling [1].
Head
Falling out of head at forehead [1]. Pain, headache coming from eyes [1/1]; headache due to contact lenses [1/1]; headache coming from nose [1/1]; pain in temples at beginning of menses [2/1].
Eye
Photophobia from sunlight [1]. Redness [3].
Nose
Discharge watery [2]; watery discharge and sneezing [2; Cob-n.]. Epistaxis during sleep [1]. Obstruction in evening [1]; alternates with pain in root of nose [1/1]. Pain as if nose were extremely dry [1/1].
Face
Sensation as if face were burnt [1/1]. Pale discolouration about eyes [1; Ptel.]. Eruptions, acne before menses [1; Arist-cl.]; acne on forehead during menses [1/1]. Cold perspiration on face before or at beginning of menses [1/1].
Mouth
Mapped tongue [3; Tarax.]. Bad taste in mouth before menses [1/1].
Stomach
Diminished appetite during menses [1; Mag-c.]. Indigestion from eggs [1]. Nausea amel. eating [2]. Pain amel. after eating a little [1/1]; amel. eructations [1]; agg. rich food [1; Puls.].
Abdomen
Flatulence, all food seems to turn to gas [1]; from fruit [1]; after vegetables [1]. Pain after eating [3]; after milk [1]; before and during menses, and distension, causing to bend double [1/1]. Rumbling after eating [3]; after milk [1].
Rectum
Diarrhoea from seafood [1/1]; after milk [1]. Itching at night [1].
Bladder
Involuntary urination when rising from a seat [1].
Female
Offensive leucorrhoea like fishbrine [1]. Menses brown at onset [1/1]; clotted, coagulated during first day and last days [1; Nat-s.]; irregular [3]; protracted and clots [1/1]. Metrorrhagia between menses [1]. Pain in ovaries before menses, agg. stepping [1/1]. Sterility [3].
Larynx
Voice, hoarseness in hot weather [1/1]; hoarseness from talking [1].
Respiration
Asthmatic respiration in morning on waking [1]; after anger [1]; amel. copious expectoration [1]; sudden attacks [1]; from change of weather [1]. Difficult respiration and headache [1]; difficult respiration before menses [1; Zinc.].
Chest
Eruptions, confluent acne [1/1]. Nodules in right breast [3]; painful nodules in left breast [3/1]. Palpitation while lying on back [1]. Perspiration in axillar regions during menses [1/1].
Back
Eruptions, confluent acne [1]; acne, cervical region [1]. Pain in sacral region during menses [1]; pain in coccyx during menses [1].
Extremities
Discolouration, white, depigmentated burning spots on upper limbs, agg. sun [1/1]. Itching eruptions on upper limbs agg. summer [1/1]. Nails do not grow [1; Ant-c.]. Perspiration of hands of hands during menses [1/1]. Swelling of thighs before menses [1/1].
Sleep
Waking as from a slight noise [1].
Skin
Discolouration, itching white spots agg. menses [1/1]. Warts pedunculated, soft and small [2/1].
Generalities
Allergy, metal dermatitis [1; Morg-g.]. Flushes of heat in young girls [1/1]. After menses amel. [1; Zinc-p.]. Obesity [3]. Weakness and cold perspiration on rising [3/1].
Food
Desire: Cakes [1]; chocolate [1]; fried potatoes [1]; fruit [1]; solid food [1]; sweets [1].
Worse: Eggs [1]; fats and rich food [1]; fruit [1]; milk [1]; seafood [1]; vegetables [1].
Notes
Pituitaria posterior
Pitu-p.
Signs
Neurohypophysis. Posterior lobe of hypophysis.
Releases the neurosecretory hormones oxytocin and antidiuretic hormone. Oxytocin is produced in the hypothalamus and then transported to the neurohypophysis, where it is stored. It causes uterine contractions at term and promotes milk release during lactation. Medically used for the induction or stimulation of labour, in the treatment of postpartum haemorrhage and atony, and to relieve painful breast engorgement. In males oxytocin stimulates the secretory ducts of the testicles.
Antidiuretic hormone, or vasopressin, is also produced in the hypothalamus and then stored in the neurohypophysis. It promotes the reabsorption of water in the kidneys [= antidiuresis], raises the blood pressure and plays a role in the water balance and production of milk. It also stimulates the storage and recall of information in memory. It narrows the arteries of the abdominal organs and is therefore used to stem haemorrhage involving abdominal blood vessels. Large doses may produce cerebral or coronary arterial spasm.
Injury of the neurohypophysis gives rise to the symptomatology of diabetes insipidus. Proved by Hering Proving Committee in 1935 on 5 subjects with 12 DH.
Compare
Pulsatilla. Natrum muriaticum. Phosphorus. Sulphur. Aristolochia clematitis. Calcarea iodata. Ferrum iodatum. Hedera helix.
Region
Mind. Gastrointestinal tract. Female organs. Circulation.
PECULIARS:
M Anxiety at beginning of night.
Obsessional ideas related to urogenital sphere [fear of becoming impotent; fear of involuntary loss of urine].
G Amenorrhoea and atrophy of mammary glands.
G Angioneurotic oedema.
G amel. Open air.
P Headache; extending downward from occiput.
Throbbing and pulsating; hypertensive.
agg. Heat; closed room; late afternoon.
and Throbbing of temporal arteries and carotids.
P Copious salivation.
Saliva tastes salty.
P Constriction of rectum.
"Wishes to evacuate stool but can't."
P Involuntary loss of urine [a few drops] when rising from seat.
P Dysmenorrhoea.
Pain day before and first day of menses.
P Difficult respiration and profuse expectoration, watery, salty.
P Discolouration of skin; white patches ??? dark patches.
Skin very dry, scaly.
Rubrics
Mind
Anxiety at night [1]. Indifference to everything [2]. Weary of life [3]. Involuntary weeping [1].
Head
Pain in occiput extending down back [1].
Face
Discolouration, brown spots, chloasma during pregnancy [1/1].
Female
Sterility [1].
Skin
Moles [1].
Notes
VITHOULKAS G., Talks on Classical Homoeopathy - The Esalen Conferences 1980 - Part 1 (vh2)
Chapter 21
Amenorrhoea
Pituitaria posterior (old abbr.)
(pitu.)
Case
This is a young woman, 23 years old, 4 feet and 9 inches tall, weighing 90 pounds. When I first saw her in December 1978, she had had amenorrhoea for one and a half years.
George: So by the age 21 menses had stopped.
Response: It had started at age 18.
George: That is what I wanted to say. You will see in the history of that person either that she had one or two periods of menses and then stopped or that the menses started very late. Immediately you can see the seat of the trouble. Yes? So I am just warning you that in such cases where you see such deep troubles, the pituitary gland is involved, and you cannot expect to have a cure within a month or two or even a year. In order to bring about menses, which may pick up in some way in spite of her being 23 years old now, you have to take care of her for at least 3 years. The depth of the diagnosis is such that you cannot expect a fast cure. You will be disappointed. So that is why we have to know a little bit of orthodox medicine. The prognosis here is long, but not perhaps incurable.
Continuing: Amenorrhoea can be underlined three times. She has a tendency to gain weight. Since age 15 or 16 she lost 20 pounds on a very restrictive diet. Then she had to stay on something like 500 to 600 calories a day in order not to gain weight. She goes on hunger binges. Then she would have to starve herself afterwards. At this point she had a diet because of glucose intolerance. The sugar curve was very high and very low.
At that point I had just started using homoeopathy and I was a little afraid to use it in her case and so I put her on a diet. She got quite a bit better and I saw her again in August of 1980. At that point, her glucose tolerance curve was much better and she was feeling much worse. In August she was feeling quite mentally and physically depressed. She had anxiety about the future (underlined twice), and anxiety about health (underlined three times). She had weakness (underlined three times) and was tired from the slightest exertion. She cried easily and preferred to cry alone. She rarely feels anger. She is worse with cold - chilly.
George: This looks like a Calc. at this point.
Question: Would you explain the underlining?
Response: Amenorrhoea (3 times), tendency to gain weight (3 times), depressed (2 times), anxiety about future (2 times), anxiety about health (3 times), weakness (3 times), cries easily (2 times), chilly and worse with cold (once). She also had dizziness on waking. When I went home this weekend I had a note in my office from her. She had continued her 700 calories a day diet with 2 cups of coffee a day. This, was strong coffee, without sugar. She says that she was sticking to this, except when she goes on a binge. She craved bread and butter (underlined three times). She would eat something like 3000 calories on one evening and then starve to death for the next week.
She says that one and a half months ago she had one day of menses. I gave her a remedy a month ago. This was the first remedy in September, but she has been drinking coffee since then.
Question: Was she craving bread and butter before the remedy?
Response: Yes.
George: So on this symptomatology, which you give us now, we have to prescribe?
Response: Yes, that is the case.
George: Do you have feedback on that?
Response: Yes, she wrote to me and said that she was much more depressed. She felt that she was at the end of her rope. She had been wanting to go and see an endocrinologist and she thought that thyroid was her only hope.
Question: If she is ready to go to an endocrinologist that fast in a case with this long term prognosis, it is going to be a really difficult case.
George: There is some information lacking. What about fruits?
Response: She has no real cravings except for bread and butter.
George: Are there any aversions?
Response: No. No aversions and no cravings either.
Response: In my experience it seems that in cases like this food cravings are irrelevant. They just stuff themselves with any sort of food. It all comes out in one direction and that direction could change at any time.
Response: But if she binges just on one item, we have to take that into consideration.
George: There is one thing that I would like to warn you about in such cases: they are very dangerous and one has to be very careful not to suppress them because they can easily go into mental disturbance. VERY EASILY!
Continuing: This young woman is not depressed ordinarily. She feels that the depression is from physical sources because at times she feels very cheerful and happy.
George: With the kind of constitution she has, there is a tendency towards diabetes.
Continuing: She is a college student right now and she is doing very well. She is VERY bright.
Question: George. Is this a case where you would have to be careful in giving remedies?
George: I wouldn't worry as much about the remedies as I would worry about that diet - 500 calories.
Continuing: I think she has been malnourished for years.
George: And also coffee at that stage is a very dangerous thing. It has given her a stimulation in order to do homework and so forth. If that girl takes a remedy by the time of her examinations, you will have a mental case on your hands.
Question: Was she only 110 pounds when she was 15?
Response: I think so, yes.
George: She is a responsible person who is able to work with her mind. They feel responsible on an emotional level.
Now, what are you going to do in that case? First you see that it is a tricky case. It is a case which is not going to be easily managed. There are underlying currents in that case. You see a girl who is very soft. Therefore you would expect to have some inferiority complexes on one level or another. At the same time, she is intelligent and she is doing well in college. But she says she is taking two cups of coffee a day. Why? Because coffee stimulates her and she is ambitious. She wants to replace the lack of height with being first in school. That drive is quite strong. She wants to be like that. You are going to interfere in that case as a health professional. And you have to correct the health. That is all you are interested in. But she is not interested in that. She is interested in being first - that is of primary importance. So you have a problem which you will have to judge in how to handle it.
If you are very strict and you say that she has to eat in order to pick up weight, it is important for her to have the stamina. Take away the coffee, which will not give the extra energy for the mind to work, and she will find herself very soon gaining weight and feeling stupid.
Continuing: She followed the diet I gave her for a week and gained a pound.
George: She gained a pound. They are afraid of picking up weight to the extent that it becomes a fixed idea - an obsession. So you have to know the problem with which you are dealing here. It is a complicated one. She is going to lose her health completely and if you explain that to her she will not understand it. So you have to find a way to compromise. Anyway coffee must go out. You cannot give a homoeopathic remedy with coffee. She is making herself diseased by her approach to diet. So the diet must be corrected definitely.
Now the third point is the remedy, you are going to give, a remedy which you know is not going to act perfectly because first of all the picture is not clear. Secondly the pathology is deep. It is a malfunction of the interior. Are you going to correct that and how much? You have to find out what the parents are like and the brothers and sisters.
Response: There is no illness in the family at all. The mother is obese.
George: That gives more help. Apart from all that, now we have to find a remedy to prescribe. What are you going to use as far as symptomatology is concerned? How shall we proceed? We shall go to the repertory. We have to take a few symptoms and repertorize it as close as possible. Which symptoms shall we take for repertorization? Give me three symptoms.
Response: I would look on obesity and anxiety about the future and cries easily.
Response: I would look under the rubric "dwarfish".
I would be tempted to use something like "dwarfish amenorrhoea" and "anxiety about health".
Response: Is this anxiety about health really anxiety about her weight?
Continuing: No, I think that she is really concerned because she realizes that she has a very severe metabolic problem.
Response: I would use anxiety about future, and dwarfishness. I would look at the bread and butter issue, but I do not believe that that is as important. The whole tendency about her working and achievement orientation, I feel, should be examined.
Question: Does she have any hair on her face?
Response: No, there is plenty of hair on her head, but none on her face.
Response: I have a hard time making a case out of that.
George: You can play with it and take three and first time and see which one comes and which you do or do not like. Then take another three or four and repertorize them.
Response: Okay. I would say bread and butter, anxiety about future, and dwarfishness.
Response: What struck me, as the interviewer, was this remarkable control that this woman kept intellectually. It has been all these years that she has kept herself under this kind of control. She could go through the day having two cups of coffee, some nuts, a carrot, an apple, and that would be all that she would have for a week or two. That was every day.
George: That would go into a state of anorexia nervosa. This is VERY bad.
Response: She should be put on a very good diet.
George: If we look under amenorrhoea, there are too many remedies. Tendency to gain weight is something I keep in mind, and I would look under dwarfishness.
So I go and look at what is most underlined in the mental sphere. There are certain symptoms which are underlined such as anxiety about the future and anxiety about health. I would compare the two and find which is the remedy that pertains to this.
There are too many remedies related to weakness. So I have to compare these remedies with another symptom which is valid. Cries easily presents too many remedies again. Chilly gives too many remedies for us to pinpoint.
I am using the repertory as a tool now. So immediately I go here to desire and aversion symptom which are very strong. For the time being, I can use that and see what is running through.
(George assigns various desires and aversions to members of the group to look up).
K.: Agar., Bell., Ferr-p., Grat., Hydr., Ign., Mag-c., Merc-d., Puls.
Response: Puls. (numerous times).
George: I got down to these two remedies (indicates on the blackboard). You go now and look in the repertory: Puls. and Sulph.
So we have dwarfish in Sulph. In amenorrhoea we have all of them.
Comment: And Ferr. is under craving for bread and butter.
George: Which would be the remedies that have weakness?
Responses: Bry., Calc., Nat-c., Lach.
Question: Are you confident you can come up with the right remedy by doing this?
George: No. In this case we are not confident. We said in the beginning that it was a different case and it would not be a straightforward remedy. Therefore we need to look again and again for one more reason that it is a different case. Forget about being accurate here in the beginning. Let's try some other combinations. What else can we try?
Another way to start is with obesity, anxiety about the future, anxiety about health, weakness, cries easily, chilly. We feel that we must think that she is suppressing something, but she does not say so, so look under suppression. Finally we take the dwarfish. So we will probably come down with Calc. or Puls. also.
Group Response: And Sulph.
George: These three now have certain similar characteristics and peculiarities. Bread and butter is Puls. The question is whether she is a chilly Puls. We can judge this from the essence. Cries easily is Puls. Prefers to be alone is not underlined. Did she cry during the interview? She is an intellectual.
Response: No, she feels that crying is a weakness.
George: What else can we use here? There is not much left that we can use. So we say she is a dwarf and we give Bar-c. (Laughter) Wait, there is another surprise in this case. This is an idea we have. Because she is a dwarf and because there is amenorrhoea, that means ... Bar-c. is very intelligent?
Response: No.
George: So again Calc. is no good. It is not Puls. Why is it not Calc.?
Response: Too intellectual.
George: Okay, let us discuss Calc.
She is an intelligent person and puts on weight easily. She is ambitious. I would be afraid in that case to give Calc. Why? Because the chilliness does not have the chilliness of carb. But the person who is undernourished is bringing up some chilliness anyway.
When she goes into mental characteristics, why doesn't that go to fears at all? Calc. whose mind has broken down and has gone into a kind of mental symptomatology will not go into anxiety about health and become depressed etc. She will go to fears and anxieties. If this had said here, "fear of insanity", I would go with that because I had a strong symptom.
Desire for sweets, which appears with Calc., does not appear at all. The vertigo from high places is not apparent. There is no characteristic symptom apart from being obese. But Ferr. also is obese, so why not use that?
Because the Ferr. is obese, is cold, and desires bread and butter - very salty. So the best prescription from our point of view would be that. Now there is another point here that says "weakness from slightest exertion". That is Ferr.
But we do not have again a characteristic of Ferr., which is "working (walking) slow ameliorates". And in Ferr. there is the circumscribed pseudo ........ They are plethoric people and you see a healthy individual. That is how a Ferr. looks - a very healthy individual with red cheeks, white skin, and very little stamina and palpitations. They will get palpitations very easily and with the least exertion.
All of the remedies which have been named are to me no good. I have no complementary symptoms to back any of them.
I will tell you something now that you should not use frequently. You would use it only when you have to make an analysis like this. And you know that the trouble is one of the pituitary. The first remedy I would use is potentized pituitary extract in that case.
Response: I had a woman that I worked on constitutionally for at least a year and a half. Finally she was given Pituitary 6x and it just turned her whole life around.
George: We are allowed after that kind of analysis to prescribe like that, but please do not use this method in every case. So after you have done this kind of analysis you are justified in giving the remedy. This is after the diet has been regulated and the coffee has been removed of course. I think that she will appreciate that it is a matter of life and death.
Question: What potency?
George: I would first try a 12 potency, one every day for about 20 days. If there is no effect in those many days, I would go higher with one dose of 200. Wait for at least one month to see if there is any change in the spheres of health and anxiety, etc.
Question: Would you consider taking her off coffee and waiting? Maybe the coffee has a dramatic effect on her symptomatology. So then see what happens regarding the symptoms.
George: You can do that as well, but if you have the right remedy and you stop the coffee so that it will not kill it, you will see dramatic changes. On cutting back the coffee, you may reduce the anxiety a bit. She is trying to break down her constitution by what she is doing. She is going to bring another level of health altogether where she will have fixed ideas and become paranoid.
Comment: She is going to have to be taught the whole spectrum of health. It will take a lot of educating.
George: That is why we have to ....
Comment: It is the only chance she has.
Question: How would you assess her vital force? A 2 or 3?
George: She has a good vital force even with what she has gone through all these years.
She still has not developed a real mental case. She has a good vital condition.
Comment: I think that what he means is that your overall assessment of her total health on a scale of ten would be .... would you say that this is a sick person?
George: On a scale of ten, I would put her at five. Why? Because she says that the family is all happy. This is of great importance.
Question: I don't understand what you mean by that. Did she have three brothers who were all 6 feet tall?
Answer: Actually, she says that she has only one sister. The family is small - all of them. They are not large people. But they are not as small as she is.
Question: That is one thing that we never even talked about. Her mother is four feet five, and her father is five feet tall, then what does that have to do significantly with the pituitary of a small person?
George: It makes much less significance, definitely. The amenorrhoea still gives you the idea that there is a malfunction of the pituitary.
Comment: In a starvation like that, amenorrhoea is not uncommon.
George: Menses started late. It is a big problem. There was suppression.
Question: So before Calc. will get depressed and develop so many anxieties, they will go through a stage of fears?
George: Yes. No, not stage of fears in general, but I would expect here that instead of anxiety about health, I should have thought that if it was Calc. that her mind would have gone towards fear of insanity, associated also with the coffee.
Question: And also the lack of desire for sweets?
George: Yes. She doesn't say anything about sweets. And she is eating so little.
Comment: This is a warm climate here in Southern California, I don't think you can put too much emphasis on the chilliness.
George: It is a warm climate and she is chilly, then of course we would put more emphasis on that. Normally she would be warm because it is a warm climate. Now she is chilly. So before I would try Calc. or Ferr., and I don't like either, I would try potentized pituitary extract and I believe that there is going to be an improvement. In consequence there is going to be a remedy on another level which will appear.