-GEORGE VITHOULKAS
French: Ambre gris
German: Graue ambra
English: Ambergris; Gray amber
Animal substance
Ambra grisea or Ambergris is a grayish, waxy pathologic secretion from the intestine of the sperm whale and is found floating in tropical seas. It occurs as a flammable, waxy mass, insoluble in water with a melting point of 60o C.
It contains cholesterol and benzoic acid. Along with its Homeopathic use it is also used as a base for perfume.
Mode of preparation: Trituration and tincture
The essential features
The key word that best describes the mental emotional state of an Ambra grisea case is INHIBITION. Most of the symptomatology of this remedy revolves around the idea of not being able to loosen up, to relax and “exchange”, to let go when in the company of other people. Yet when we read the excellent exposition of Kent on this remedy this idea does not come across clearly. Stress has been given to the state where the patient talks incessantly, without really understanding what she is talking about, while asking questions without waiting for an answer and jumping from one subject to another. I believe this description capable of giving a wrong impression to the student. It was so with me until I met some severely inhibited cases that were unable to open up and would give no information and yet were constitutional Ambra grisea cases. Then I knew better. Then I understood the inner structure of this remedy.
An Ambra grisea case is manifested when the person comes face to face with the idea of “failure”. This idea can indeed easily be imposed on them by others, in cases were they might put them down, or alternatively the cause might be an objective situation in which a heavy loss in their business or some embarassment in their work might have been incurred. They seem to loose their self-confidence instantly, they retreat into themselves and eventually develop a tremendous bashfulness, a peculiar timidity when in the presence of others. It is as if they were tied up in knots; the mind seems to stop working, and it becomes impossible for them to express anything. Ideas do not emerge if they are with other people; if someone is present the mind becomes cramped, inhibited, perception is lost and the expression nullified. It is impossible for them to open a conversation with others especially if they are not well known. In the text it says “aversion to conversation” but the real cause is the state of their mind. There is no reflection, no real perception of the situation.
But Ambra patients are emotional, sentimental people who suffer tremendously from this crippling inhibition. They need to express themselves, but in the company of other people they become mute. As a result they start to phantasize in order to balance their psychological needs. They are people who are easily excited and easily depressed. One can easily perceive the inconsistency of their idiosyncracies. They are especially sensitive to music, “the tones seem as if they were a material substance taking hold of him”. Kent attributes aggravation to music to the fact that their hearing is diminished. From the cases I have seen I have understood this aggravation to come from a different level: As music brings about an emotional reaction, and as at the same time they feel incapable of responding to such a reaction in a natural way, that is to say, by letting out the emotions that have been stirred up by the tones of the music, the resulting conflict created within themselves leads to intolerable and extreme aggravation. They tremble and have palpitations; they suffer from a host of symptoms, including even pains in the back, while listening to music. Sometimes the stirring of the emotions is such that they will feel like weeping all the time. This last symptom shows how deeply music can touch their emotions.
We come now to their sexual life. In view of their mental-emotional make-up it is easy to understand the problems that will be encountered in their sexual life. While they are easily excitable and aroused sexually, tending to fantasize and yet unable to bring about and sustain a proper relationship, it is understandable that they will easily resort to masturbation. It is a desperate situation which brings into conflict the desire for physical contact and their inhibition: they feel the need for physical contact, they even have lascivious thoughts and fancies even in their dreams, yet they are so inhibited, and timid and easily embarassed that it is very difficult for them to establish a relationship. As a result we see constant and long term masturbation with feelings of guilt.
In our modern society you will find that almost all these cases have already had several sessions with the psychiatrist, not to mention the psychologist. Actually in the end they may become psychologists themselves. Such is the psychological torment they undergo in their social life. It was with one such woman psychologist for whom we were not able to find the correct remedy, since she gave no symptoms, no reason for her chronic colitis, that I investigated deeper and found this tremendous inhibition which put me on the right track. Even once she appeared to have overcome several of her problems of expression, she would intellectualise and mention only those symptoms that did not touch upon her real mental or emotional problems.
Ambra patients may have been people with a lot of confidence and a certain degree of egotism in the past, who, after a “failure” or the stress of an offending remark or the pressure of a business embarassment or the trial of a series of deaths of people on whom they relied, have changed, and gone to the opposite extreme; they start seriously questioning their mental abilities, they lose their confidence entirely, they lose their self esteem and their mind becomes almost paralysed with thoughts of their inability.
From this point onwards you will notice that they start to avoid meeting people; the mere idea of meeting a new person on a business appointment or socially sends them to pieces. Anticipating a meeting with people is torture for them. They feel they cannot make an effort to do any mental work; they become physically indolent, they feel weak, nervous, fidgety, aggravated by noises. They cannot fall asleep easily, they fall asleep quite late.
It takes on their part a tremendous effort to keep up a conversation, they actually do not feel their own self to be present at the moment of a conversation, they tremble, twitchings come to their face, a dreamy or a cloudy state overtakes them and any ideas they might have had seem to vanish. The rubric “aversion to conversation and aggravation from it” has to be understood in this context.
There is such difficulty in communicating with others at any level that the sight of people laughing creates an aversion to laughter, almost a disgust! This symptom cannot be understood, however, unless we perceive the whole picture of the remedy. Laughing is a free expression of the emotions, manifest when a person feels free to externalize completely their state of emotions at a given moment, and it is an expression that almost demands a participation from the other person. Yet the inner state of Ambra cases is such that they cannot “let go”; they cannot bring themselves to a sufficient state of relaxation to participate in this most natural condition. Naturally, as a result, they are embarassed, and aggravated. The point that must be understood with Ambra people is not that they never laugh, but that, with strangers present at a social gathering, their state of mind is so confused that if a joke is cracked they will not grasp it immediately and therefore will not like to see others laughing. They are in a state of embarassment. In this way “the disgust from seeing others laughing” that we encounter in our Materia Medica can be fully understood.
The timidity, the bashfulness the inhibition of an Ambra Grisea case are unbelievable. This remedy is many times confused with Bar-c., Gels., or Alumina. When they feel this bashfulness their face becomes red and “boiling” hot.
It is impossible for Ambra Gr. to appear in public and give a speech. We often see a claustrophobia, an aversion to crowded areas or narrow places. In the presence of other people, Ambra’s personality seems to be minimised and eventually almost totally eliminated: they become non existent. They feel completely inhibited, cannot express anything and of course any conversation that demands their presence of mind seems to aggravate them. They become irritable, restless and anxious during a conversation and any pain they may have is aggravated. In fact when they are stirred up emotionally, instead of expressing their feelings to others, they start experiencing pains and aches and discomforts inside their own body. This weak state of mind could be identified with a state of mind that is breaking down, that is weak, that is prematurely old.
If such a state is left to undermine the constitution, we may eventually see a situation such as that of an older lady, who, having made a conscious effort all her life to participate in social conversation, seems gradually to have divorced herself from reality, and in a hazy and dreamy state of mind will keep up a bizarre conversation, jumping from one subject to the other, asking one question after another without waiting for an answer. It is a type of insane behaviour.
We see an unbalanced state of mind where the person has decided before the meeting to behave “socially” to talk to everyone, to overcome his shyness etc. but as soon as he is in the presence of others the mind becomes clouded, weak, hazy, the hands tremble, the face twitches and it becomes impossible to sustain a proper conversation.
Kent describes this state beautifully. He writes: “We recognise trembling and a peculiar kind of feebleness that cannot be described by any expression but senility, it is not the confusion of mind belonging to sickness, but the peculiar state we recognise in old people, in declining life. Trembling and tottering and a dreamy state of mind with forgetfulness. He goes on from one subject to another, asking a question and without waiting for it to be answered, asking another. And so he jumps about from one topic to another. It can hardly be said to be confusion, it is a dreamy state of mind, a state of senility. This remedy is useful when such a state is found in young persons, when the mind is not insane and yet is weak. It is especially indicated in those persons who manifest a momentary, fleeting inquisitiveness, jumping from one subject to another.”
Yet, I think, in actual practice, the patient will very seldom tell you that “I keep asking questions not waiting for an answer”, or that “I jump from one subject to the other”. However, if you have thought about this remedy during the interview and describe this behaviour to her she will recognise it and admit it promptly.
In a constitutional case of Ambra grisea, it will easily be established from the patient’s description that the most prominent elements in their mental/emotional symptomatology are inhibition and timidity, such states taking precedence over the dreamy state of mind discussed above.
The torture felt by Ambra grisea when appearing in public to make a speech, or when in the presence of other people, is so great that many of them eventually become misanthropic. They will seldom go out with strangers, preferring always the company of people with whom they feel secure.
The main idea that we have been describing so far, namely that of inhibition in front of others, or in the presence of people who are not familiar, happens during stool as well. It is impossible for the Ambra case to “let go” and have a stool with anyone present. In hospital they cannot have a stool in the presence of a nurse; in the house of a friend they cannot have a stool out of the mere thought that something can be heard by those outside. Even in their own house, knowing somebody to be near the toilet, who may hear the noises of a natural evacuation, can cause them to sit on the toilet and go into a state of anxiety with an ineffectual desire for stool, but without the organism being able to relax and let the stool go. In order to have a normal stool they must be quiet and alone in the house. This also applies to urination or the emission of flatus.
Every student of homeopathy knows that this is a keynote of this remedy; we must always look at the overall picture of a remedy, however, before attempting to understand a local symptom.
It is also in the nature of this remedy to have a tremendous concern about others: “what will they say”, “what will they think about me” are typical exclamations, especially if something “bad” comes out. This idea pervades on all levels, and it is an idea that seems to affect Ambra Grisea cases so deeply that it inhibits all natural expression, all natural eliminations! This is the way to understand the essence of this remedy.
They may perspire and feel anguished for no reason, or because the perspiration might be offensive and bother others. They go to tremendous lengths and out of their way to please others, not to offend or displease. They can never say “no”. “Sometimes I decide to say no but at the last moment I cannot. Once I said no and then I felt bad.” This is a typical expression. The idea that others might put them down by an offending remark terrifies them. Thus we see that Ambra Grisea patients try to please everybody except themselves.
It is easily understood now that if this state is left to progress we shall eventually witness a gradual degeneration of the condition of the patient’s mind. Further symptoms include forgetfulness, dulness of the mind, a state of mental torpor, where what is read is not understood; the same sentence must be read two or three times for the meaning to sink in to their conscious mind. They are unable to calculate.
Difficulty in thinking and comprehending. “He has to make an unusual effort to bring his thoughts back to the place before he can concentrate the mind to meditate upon the same idea. He gets up in the morning with dullness and confusion of mind and is in a dreamy state and towards the evening takes on symptoms of insanity”. The power of reflection is lost and the capacity for mental work is minimised.
Eventually, these initially excitable people fall into a state of indifference, where they do not care about anything. “…He treats with indifference things that would naturally break the heart of a well-balanced person. He does not even wonder why he is not excited over these wonderful things, so decided is the state of indifference.”
Periods of excitability and periods of indifference alternate for some time until sadness, depression, despondency take over and become more or less permanent. Accompanying this state is a feeling as though they were going insane, with desperation, and no desire to live. Loathing of life. They have delusions, imaginations; he sees diabolical faces crowding in on him; he sees hideous faces. He has delusions that there is too much light in the room while falling asleep. When going to sleep she sees herself doing things and has other visions also. He has visions on waking, sees windows full of people, strange lights etc, and the visions frighten him.
Once in a state of depression, Ambra grisea sits wrapped up in deep, sad thoughts and takes no notice of his environment; he broods over past experiences: incidents that took place long ago are continued as vivid reality. Disagreeable things from the past force themselves onto his mind. He cannot get over old events where he was hurt, and his mind comes back to them again and again to be tormented. Similar to Natr-m. with the difference that Natrium actually enjoys delving into such painful experiences. “Haunted by persistent unpleasant subject”. This dejection, this sadness sometimes give way to irritability, to vehemence, with quasi insane behaviour, cursing, with impulses to yell and strike out. In his rage Ambra Grisea has the fear that he may kill his child and feels he is going crazy. It is an alternating state that resembles manic depression.
To conclude this description of the mental/emotional picture, I would like to pass a remark concerning this remedy: almost all our Materia Medica’s stress the hysterical aspect of this remedy, which I have not experienced in the cases I have seen so far; the only aspects of this remedy which I have encountered are the ones described above. I mention this so as to remind the student to keep this information in mind, and apply it, when faced with the typical hysterical Ambra Grisea, which I have yet to encounter myself.
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