The mother sits opposite me and sounds concerned. Her youngest son is the patient and about whom she talks, yet he has refused to come to see me. I close my eyes and try to picture the five-year-old boy as his mother adds detail to the image.
“Adam is stout, with short blond hair and blue eyes. Even though I never caught him biting his nails, I suspect him of doing so. He has three sisters; two are older, the youngest one is two years old.”
The mother pauses.
“When did his problem start?” I ask, avoiding the direct question about what actually constitutes his problem.
“Two years ago.” I note that this coincides with the birth of his younger sister and the mother nods without offering more information.
“What kind of kid is he?”
“He is afraid of new things. Every new situation scares him. He is also terribly worried that he isn’t loved by the family and that he gets the short end of the stick all the time. And he can be very stubborn.”
I repress the knee jerk response of Calcarea and remind myself to leave more room for my opposite to fill the spaces. Or else this interview is going to turn into one of those question and answer exchanges where the patient just says, “yes” and “no.”
“Adam just makes up his mind about something and that’s what he has to get. Otherwise he throws a terrible temper tantrum, which lasts 10 to 20 minutes. Afterwards he excuses himself and seems embarrassed.
“He dominates younger kids and only plays with smaller children. He prefers calmer games and isn’t very active, physically. He likes it best when his friends come to him, and doesn’t like to go out. Adam prefers the known; he needs it for his protection.”
Ah, so it is Calcarea after all-or so I think.
The mother goes on: “He behaves normally at home and only seems to be clingy when we go out. He is most secure at home. Adam is a very cautious child. I would never be afraid that he would dash across the street. He never tries anything by himself.
“He doesn’t like it when I drive on the highway. This is way too fast for him; he gets sick. He watches the speedometer and reminds me when I exceed the speed limit.”
I nod as I write this down and keep looking at my notepad.
“Two years ago my sister told me that Adam had asked his younger cousin to sit on him and take off her shirt. He threatened her and said not to tell anybody.”
“Is this the main problem that you came to see me for?” I ask her, and she nods. I understand that in a small rural town of maybe 100 people this problem can be very damaging to the reputation of a hard-working mother and her family.
“At this time Adam developed a red rash over his pubis. He asked me to examine it every day and got an erection each time. The rash wasn’t itchy and didn’t hurt. I learned bit by bit from other kids and their parents that Adam had had sexual contact several times with younger boys and girls. I, myself, have never caught him masturbating.
“His penis is too big for his age.
“Adam is very pedantic concerning hygiene. He doesn’t go to the toilet without meticulously washing his hands afterwards. When he goes out to play he asks me if he will get sick if he can’t wash his hands later.
He behaves as if his life were hanging by a thin thread
“He is very suspicious. Whenever my husband hugs me or we happen to be in the same room together with the door closed, Adam asks us what we have been doing. The door needs to be open all the time so that he can check on us.”
This information came in one narrative without my prodding or interrupting. I feel that it may be time now to change the subject slightly and return to this topic later if necessary.
I learn that Adam wraps himself in his blanket at night and wears pajamas all the time. He likes food rich in carbohydrates, sweets, chicken, and eggs. He dislikes onions and meat other than poultry.
His mother tells me about his dreams, that they are wild and brutal with burning houses and dying people. Besides the fears she already told me about, Adam is afraid of dying and of getting cancer. He is mortified by thunder and lightning.
From the entire interview I get a feeling that on some level, the mother is more deeply involved in this story. In these cases I routinely ask about the circumstances of life around the time of conception as well as the pregnancy and birth.
“Seven years ago my father separated from my mother. She took this very hard and had to go to the hospital after an unsuccessful suicide attempt. After this I didn’t want to leave her alone and stayed with her. This was a very stressful period, and on one occasion I must have forgotten to take the Pill. During the pregnancy I had huge financial problems. I felt alone because my husband attended evening courses and I had to look after our business, my mother, and the two children all by myself. I had many worries and was close to despair.”
My ensuing questions didn’t turn up much new information apart from Adam’s dislike of loud noises and that he wanted to be carried all the time.
The theme of this case, as acted out by the young boy, is present even before his birth and can be found in the situation surrounding the time of his conception. His mother describes a very insecure time for herself when she nearly lost her own mother. Financial problems, much worry, and grave sorrow predominate. She had to deal with this all alone, since her husband is mostly away attending courses.
The vital threat she experienced then and the fight she had to put up are now reflected in the violent dreams of her son and in his insecurity. He requires constant support from his parents and can’t be left alone. Every new situation frightens him. He behaves as if his life were hanging by a thin thread. Any disturbance could be too much and cause the thread to break. This is how I understood his obsession with cleanliness and his fear of disease.
It is easy to produce a brilliant case analysis leading up to the curative remedy in hindsight. Rather than succumbing to this temptation, I would like to follow my train of thought at that time. As happens so often in everyday practice, the full extent of the puzzle’s beauty reveals itself once we know the simillimum. This is when true understanding of materia medica occurs and remedies etch themselves indelibly into our memory. Therefore, I am going to mention some of the insights this case taught me in the closing paragraphs.
The center of the case is clearly on the mental/emotional plane with nothing particularly distinctive in terms of physical or general symptoms. For this case I focused on the main theme of insecurity.
In some cases, such as this one, several central ideas stand out and are easily identified. I imagine them as threads woven together to make up the totality of the case. Instead of trying to select only a few distinct rubrics for the entire case (which sometimes is a very good strategy), with this analysis method I take a broader view. I collect rubrics for each theme until I can be reasonably sure that they define it well enough, while encompassing a large enough number of remedies so that the simillimum is very likely among them. The trick is to find a balance between breadth and precision.
Then I combine each group of rubrics into one “superrubric” which contains all the remedies in the highest grades in which they occur in the individual rubrics. This is easy when you use a computer to do the dirty work for you, but it can be done by hand just as well, albeit a bit slower.
Let’s get back to Adam and the theme of insecurity, which emerges throughout the case in several different forms. For example, Adam’s fear of diseases, his anxiety in new situations, and his being so uncomfortable in fast moving cars. Adam’s strong aversion to dirty hands is interesting in so far as it can be easily translated into repertory rubrics. It is tempting to favor symptoms for which we already know the rubrics. To me, in this case, Adam’s cleanliness is a variation of the “insecurity” theme as expressed in his fear of disease. It wasn’t his disgust for dirt that made him wash his hands so arduously (as would be the case in, say, Lac caninum or many other animal remedies.) Rather, it was his fear that he might catch a disease.
My first group of rubrics looked like this:
Fear of disease:
1. Mind: Fear; cancer, of
2. Mind: Fear; disease, of; incurable, of being
3. Mind: Fear; disease, of, impending, contagious, epidemic, infection
4. Mind: Delusion; imaginations; dirt, dirty; he is
5. Mind: Washing; always, hands, her
Then, of course, comes to mind the strongly expressed fear of thunderstorms. Again, this is one of those rubrics easily identified in the repertory and therefore all too gladly used as a pillar of one’s analysis. I grouped it together with other, more general expressions of Adam’s cautiousness.
Cautious about new things:
6. Mind: Fear; thunderstorm, of
7. Mind: Cautious
8. Mind: Suspiciousness, mistrustfulness
9. Mind: Obstinate, headstrong
The last symptom in this group, Adam’s obstinacy, I interpreted as his reluctance to let go of a familiar idea. Therefore it made sense to me to add this symptom to the other ones in this group.
Lastly, I took the main complaint concerning Adam’s hypersexuality, exhibitionism, and tendency to masturbate. There are many rubrics which capture this tendency, and the scope of the rather small selection I picked can be widened considerably if one looks in the dreams and delusions sections of the repertory.
10. Male: Sexual; desire, excessive, children, in
11. Male: Masturbation; disposition to, children, in
12. Mind: Shameless; exposes the person
13. Mind: Lasciviousness, lustfulness
In addition to these three themes I took Adam’s fear of thunderstorms as a strange, rare, and peculiar symptom according to §158 of the Organon. To give it more weight in the repertorization I added it as an individual, ungrouped symptom as well. In the end, my repertorization looked like this:
(The numbers in parenthesis indicate the size of each rubric.)
The repertorization shows only those remedies which come through all rubrics. This is about as far as you get by using only the repertory. To decide which, if any, of the remedies from above is the simillimum, I had to reach for my material medica books. In the end I chose Borax, with Carcinosinum and Calcarea also making it into the final stages of analysis.
Prescription: Borax Q1 [LM1], five succussions before each dose, one tablespoon of the first dilution to be taken once a day. (To those with questions about the posology I use in most chronic cases, I refer to Homoeopathic LINKS, Vol. 9, Winter 1996, pp 186-8, as well as to the sixth edition of the Organon.)
Follow-up at two weeks
The mother sounded very happy and told me that Adam is able to let her out of his sight much more readily. Also, his attitude towards his younger sister has changed considerably. He is much more loving now. (This was a symptom which she hadn’t told me about in the initial interview.) He also stopped biting his fingernails.
I considered this a very encouraging success. To me, Adam’s changed behavior toward his little sister was particularly noteworthy. This is something I would have hoped for only much later in the case.
I advised to continue with the remedy for two more weeks and then to call me.
Follow-up at four weeks
Adam has just started to go to school-a moment dreaded by his mother, since this is such a big change for him that she was very worried how he would take it. Surprisingly, there were no major problems, and Adam is proud to go to school. Driving in the school bus with all the other kids is no problem. He likes doing his assignments which previously, in kindergarten, he hated.
The fear of driving fast in a car has disappeared. Adam has become much more secure and self-assured.
The loving attention he gives his younger sister still continues. He comforts her when she cries.
His nail-biting is still gone.
The mother describes him as a completely changed child.
There doesn’t appear to be a need to take the remedy any longer. I advised to stop the remedy in order to see how long the impetus would carry.
Follow-up at five weeks
I hear from Adam’s mother one week later by phone. She tells me that Adam has started biting his nails again. He is fearful and insecure, just as he was before.
The interpretation was not hard. It is a relapse after one week off the remedy. Therefore I told the mother to continue with Borax Q1, but to give it only twice weekly instead of daily. This should be sufficient to provide sufficient stimulus while not inflicting any proving symptoms in the long term.
Follow-up at five months
His mother forgot to give Adam the remedy for two weeks. Right after starting again with Borax the improvement continued and lasted. He again enjoys school, plays with his little sister, and doesn’t bite his nails.
Therefore I told the mother not to give him any remedy.
Follow-up at eight months and again at two years Adam is doing fine.
Since Adam’s case, I have had one other successful case of Borax. What both have in common is the fear of fast motion. Of course I know that Borax is known for its fear of downward motion. Who doesn’t remember the description in our textbooks of the mother putting the baby down and he starts to cry from fear of this motion? In older patients, however, the fear seems to be more of moving fast.
Adam’s mother has taught me how to understand the remedy better. The life situation in which she conceived Adam was very revealing. She was afraid that she would be losing her mother. In addition she had grave money problems and was left to deal with everything all by herself.
This is a situation where things seem to be hanging by a thin thread. Just a bit more and the thread will break, and everything suspended from it will fall down. The fear of downward motion is tied closely to this situation, in my understanding of Borax. It is the fear that the last support is going to give.
Borax patients look for support in a way that reminds me of Calcarea. And they can be rigid and obstinate, similar to Silicea. To them, any confrontation with a new situation is adding to the weight on that thread and threatens to break it. Therefore they startle at each sound, they are afraid of diseases, they’d rather go slow than fast, and they dread thunderstorms.
Borax has the symptom “Sensation of a cobweb.” It is mere speculation, but maybe to a Borax patient it is the threads of this cobweb that are about to break.
Chris Kurz is a physicist and a homeopath. He discovered homeopathy more than ten years ago on a cold winter night in Boston. Since that time he has been studying and more recently practicing in the US and Austria. His particular passion lies in the science and teaching of homeopathy.