|Neurasthenia after child birth|
George: Let us do the case which I gave you. But before I give you the case I would like to ask you why you prescribe that remedy, so it is better if I have your name. Did you discuss the case among yourselves? Some of the recommendations were Lyc., Puls. and Phos. I would like Harvey to analyze the case and tell me why he prescribed, what symptoms you found, how you evaluated it.
Response: [from Harvey, presumably]: I repertorised it using your underlining 1. A frequent remedy for me was Phos. I did not think that she sounded like Phos. because she did not sound confused. She sounded angry, irritable and focussed. Also I did not understand about the ‘fear of heat’. I gather that that means she is afraid of being in a warm room or a hot place.
George: She is afraid because she is suffering from the heat.
Response: So that also did not sound like Phos. Her fears fit Phos., but they also fit Puls. I went back and forth between Phos. and Puls. I finally decided that she sounded … her openness, her expressiveness, her irritability, her…the essence sounded more like Puls. than Phos. and this was compatible with the rest of her story and with her fears and with her relationship to sweets.
George: The fear is not an established fear, it is just, “Oh, I am afraid of the heat.” This is an expression to show how much she is bothered by the heat. Harvey says that according to repertorisation and the mental symptoms and fears, worse with heat, the person sounded like Puls. rather than Phos. Phos. was coming up often in repertorisation. This is also true with the others, eh? So some of you decided to give Phos. in spite of that. Who prescribed Phos.?
Response: Phos. can be aggravated by heat also.
George: Yes. Of course you must find this great aggravation by heat so prominent in Phos. I think we can put this aggravation by heat in italics.
Response: Kent separates Phos. out. He says that head and stomach symptoms are better with cold and worse with heat. The rest of the physical symptoms are the opposite.
George: But apart from that he says it is correct in stomach symptoms. Phos. is worse from heat – warm temperatures – but in general Kent gives it as a chill aversion. This is aggravated by cold in general. His repertory will list it as worse with heat in general.
Response: There is also a sensation of heat.
George: But not so strong. When you have a case your mind must work very fast. You take into consideration the whole case and you put it together. It is like a computer. You have to take a symptom in conjunction with all others. If you have a strong symptom, you always want to start your case with that symptom. And you find that ten remedies are associated with that symptom. Then you take another one.
Question: (The symptoms) desiring chocolate and ice-cream and sweets.
I acknowledge a lot of glaring things against it such as lack of craving for salt and the claustrophobia seemed to be a slap in the face regarding Phos. Palpitations lying on the left side.
George: What do you mean, a slap in the face?
Answer: It seemed to me to be a vote against Phos.
Response: A slap in the face is against and a slap on the back is for. (Laughter)
Continued Response: I over-read your essences and I was bothered about giving Phos. to her by the way she took her irritability out on other people. From your essence, I perceive that Phos. would be loath to do that. But may be I over-read your essences.
George: That is true.
I gave you that case because I wanted you to start reading between the lines of a case. The person is not going to give you the essence as we give it here, so you have to draw the essence from the description and the observations that you have made with your patient. Also you will have to rely on strong symptomatology which is against a remedy. IF THERE IS STRONG SYMPTOMATOLOGY WHICH GOES AGAINST THE REMEDY WHICH YOU WANT TO PRESCRIBE, HOLD BACK AND LOOK AGAIN. Don’t over-come it. I would like to hear a representative of the Lyc. essence.
Response: I felt as though Lyc. fit the main symptoms which were underlined three times especially. This was reinforced by the fact that this woman took out her irritability on the family. I thought that was quite significant. Lyc. can be sensitive to heat – intolerant to heat. And of course Lyc. fits the cravings, is afraid to be alone, and can also be afraid of the dark, and is definitely claustrophobic and irritable. Even though I felt that perhaps her underlying personality was more open, I felt that her present state of affairs called for Lyc.
George: So we have these three possibilities, we have Phos., Puls. and Lyc.
Response: For my second choice I had Arg-n.
George: Now, first I want to discuss the Phos. possibility. This case has been prescribed for, half by me and half by the attending doctor. I gave the first prescription. I took the case and I read exactly what you read and I thought exactly what you thought. Puls. You see in this case which is so much worse with heat, we will not think from the very beginning of a remedy which can sometimes be worse with heat. The heat is exaggerated. We cannot ignore this fact. Therefore I would go for remedies which are worse with heat. I made a translation of the Greek expressions, but what is her trouble really? It is that after labor she became mentally unbalanced. She had to take psychotropic medicines. On top of that, in 1976, she became much worse. She stated that she became irritable at the least cause and she would break out shrieking and shouting when there was a cause.
Can you imagine the type of extraordinary pressure? Irritable and with the least cold she coughs and spits up. This is not restrained, therefore what do we call such a person. How do you find this in the repertory? If you can imagine a person who reacts instinctively like that – impulsive. So this person is really impulsive and reacts to what is in front of her at the moment. Now how many of you want to change the remedy? I may be misleading you.
Response: I would. I would change mine to Lil-t. Not because of the impulsiveness. I don’t agree that what you are describing is impulsiveness as with Arg-n. impulsiveness where the mind is overcome with an impulse from inside. This sounds like a reactivity and irritability more than some impulse to do something.
George: Okay. You say it is Lil-t. Anyone also wants to change?
Response: Not yet.
George: This impulsiveness which this person is showing, is it characteristic of Phos. or Puls.? These remedies usually don’t act like that. We have seen mild Phos. and Puls. act sympathetic, non-aggressive. This person is good for the encounter groups. This person cannot restrain herself. She is open and expressive. Does this go with Lil-t.? She is open and expressive and you can see it. The word is nasty. Who was Socrates’ wife? When a woman is a shrew – almost a bitch, she will make a tremendous noise and will leave the house like a storm because you approached her and said, “Would you like some milk?” In her mind she thinks you offered her some milk because you want to go out in the night and you don’t want to take her with you. She goes out and slams the door and goes into a fit. And I say, “What happened?” Here we have a confrontation. We have to take into consideration these things in order to be able to track down the remedy. So impulsiveness is there and it is something at which we should look. She seems to be quite expressive and vital in her emotions. She seeks company, desires company. That is another rubric which you might have consulted. Fear of being alone and desire for company. Fear of being alone is another rubric. It does not necessarily follow that because she desires company, she is afraid of being alone. Here we have two symptoms: fear of being alone and desire for company. Does anybody want to change remedy?
Response: Arg-n. Mur-ac.
George: Now, this person…by eliminating one by one and by going thoroughly into an analysis of the case, we can find a remedy. Then she says she has anxiety about her people (underlined twice), anxiety about others (once), claustrophobia and fear of closed place (three times). This person who is expressive and vital and impulsive has claustrophobia. When she is in a closed place, she starts struggling. So where do you find claustrophobia? Do you remember the rubric? Fear of closed places. This is a person who is bothered by heat, who is impulsive.
Question: George, did you add a rubric claustrophobia?
Response: Arg-n. is in claustrophobia but not in fear of closed places.
George: So this person who is warm, who has fear of being alone, who desires company, who is expressive and wants to tell everything, and who is impulsive. This description is the best that I could relate from the Greek. Greek is more expressive, but I tried my best in the translation to keep the idea. “Never mind who is in front of me, the moment I am excited I will take it out on them.” So what is impulsive? A person who cannot restrain himself, who will react before the mind is controlling what is going to be said or what is going to be expressed. More or less we come to the idea of impulsiveness in this case, but it is not that which we should rely upon entirely. We shall see whether the totality of the case best fits Arg-n., Lyc., Puls., or Phos. This is what we are interested in, making the differential diagnosis. Here is keynote prescribing. In this case we have enough information to go by. Sometimes we have nothing else to do and we resort to keynote prescribing. You see which of these remedies is most bothered by heat?
Response: Arg-n. and Puls.
George: Which of these two remedies can create a desire for sweets? It is underlined four times and I gave you three times here. I was not careful with the writing in the addition, but it is difficult to put in an addition and put it immediately on the second level or on the third level. Do not get the idea that an addition is easy to go into the third stage before we have investigated and been certain about that symptom. We insert with care on the first stage and if we repeatedly see it happen, we may raise it to the second. But this is after much research on that symptom. Then it can be moved to the third. Puls. has a desire for sweets, but we keep it in the first grade.
Question: Isn’t it so that Arg-n. is highly characteristic of a desire for sweets?
George: This is one of the main remedies for the person who cannot go without sweets. It overwhelms in Lyc. and Sulph. and Chin., which are all given in black letters. If in this case we would not have this desire for sweets, but that she could not tolerate them, everybody would have written down Arg-n. We have to sort them out every time and hope for the best prescription. Here it is really Arg-n. which covers most of the case from all points of view. Do you see how many capitals it has? You got it through repertorisation?
Response: I did both. I analyzed the case like you are talking about. The thing that clinched it for me was (1) that claustrophobia ruled out Phos., and (2) in the sphere of her fear of robbers, where it says, “If she is alone she will search all over the house to see if anybody is inside and if she has locked the doors etc.” That clinched it for Arg-n. for me. It is an almost insane way of making sure of things, just in case. She is in a hurry and is anxious. Everything she does is in a hurry.
George: We have a fear of the dark (underlined three times). This fear of the dark is quite strong and Arg-n. is not given in the repertory.
Answer: I do not know why it did not bother me, but it did not bother me.
George: Because all of the symptomatology goes towards this direction, you can ignore that symptom and you may say that perhaps she has a fear of the dark, but it is not yet inserted in our repertory or our materia medicas. You see the ice-cream here. The doctor who took the case proposed Phos. for the reason that we said before. She desires sweets (three times) and ice-cream (twice). Now for Phos. it would be the other way around. She desires sweets and ice-cream is sweet – she likes it because it is sweet and not because it is cold. Do you see the difference? Phos. desires cold very much! But she desired sweets, chocolate, anything you could give her, and ice-cream because it is sweet. You have to be careful with Phos. here. Just for this little thing there. Not every time that we have a person desires sweets or ice-cream do we give Phos. Here, from the way the doctor underlines the symptoms, it is definitely a certain desire for sweets. She desires oysters (once). Phos. is the only remedy which is given with an aversion to oysters. Of course I have edited it and you have it as a desire for oysters as well. Desires oysters.
Response: It might also be that by this time the doctor in the case was convinced that it was Phos. and was looking for these things. Doesn’t it happen that way?
George: No, it does not happen that way. Let me see. The desire for oysters is one. We cannot rely on that desire at all. If we want to discriminate one remedy from another, we do not take a symptom underlined once to discriminate. It will have equal marks. We have “desire oysters” underlined once. You cannot take this so seriously, because it could be a desire for oysters or not a real desire. The doctor had just overcome this point and did not notice anything. He said it was a real desire where it is not – it is a normal appetite for oysters. It is not a pathology which we are looking for. Here is the pathology in the sweets. Fruits (once). Aversion to milk. Moderate thirst. The thirst that we needed for Phos. is not here. Neither the temperature of the water – it must be very cold. We had confirmation for Phos. again. So this case, though it now appears definitely Phos., it is hidden because of the way that it is expressed. So we have to look between the lines. But when we try to put things together, then finally we understand that it is Arg-n. and, yes, this is impulsiveness. What is described hereafter? We understand that there must be impulsiveness. Even from the very beginning we did not understand. When did we see claustrophobia? The desire for company and the fear of being alone and the fear of the robbers? The aggravation from heat? All these make a perfect case finally of Arg-n.
Question: What about the sympathetic characteristics?
George: We would expect Arg-n. to be sympathetic to some degree. Why?
This is an extrovert, and extroverts are usually people who are concerned with others. So she would say that she was sympathetic, but this is a natural sympathy and not a pathology here because if we see the case really it says that she takes it out on her friends. She is aggressive. Now, how does that tally with sympathetic? It is very difficult to believe that sympathy is a pathology, but it means that she is suffering so much with the other person that … When we say sympathetic and it is pathological, they are suffering so much.
Question: Isn’t it more of an anxiety about other people than sympathy? She may worry about other people but not necessarily feel their suffering. She may call that sympathetic because that sounds better.
George: Even so, this is a symptom which can be a natural thing for a woman. We can over-rule this.
Question: Doesn’t Arg-n. have anxiety about others?
George: It is not listed in the book.
Response: It has been added in the additions. “They can usually lack salt.” *
George: In this one the salt is not right. If we had desire for sweets and desire for salt underlined three times, again we would immediately have said that this was an Arg-n. case. By these desires your mind would have investigated other directions and then you would find out that this was all in place now. But we do not have a key-note here really of Arg-n. If we had desire for salt underlined three times then this too would become a keynote. But we do not have in this case, which may happen.
Question: Would you discuss sleep on the right side and the tachycardia on the left? That really threw me off. It is the opposite of Arg-n., but it is not pathological, it is common. It is not underlined.
George: The idea is that somewhere we must stop. We do not want EVERY symptom. We cannot have every symptom be recorded down in our materia medica and cover the whole symptomatology. It is not possible. And that is why homoeopathy is different. So what we try to do is to find the best solution with the given facts which might finally be the central remedy. And the best solution here is definitely Arg-n. So we find the best solution.
Question: I would like to ask about the relation of the symptoms to childbirth. This apparently all began with childbirth. It seems to me that that would be related to Puls.
George: Why? Childbirth of course means a hormonal change in the life of the woman. It is a sudden hormonal change. It seems that the organism cannot adjust itself quickly enough to bring about balance and then we have this kind of pathology. It might be another pathology in another person, but this does not indicate only Puls. There are too many remedies which may be indicated because of a hormonal change in the life. Like in an abortion you have changes and then you have a strong symptomatology after an abortion, either voluntary or involuntary.
Question: I wanted to make a general comment. I think this case is probably one of the best cases I have studied or seen that illustrates how the tendency that we all have to study the case by matching data – trying to line up data points and see which one covers say 30 symptoms and this one has 28 and so that is the remedy – versus having to see something stand out against it in the essence realm and realize that it can’t be the Phos. no matter how well it scored in repertorisation. It is a beautiful illustrations of having to look again.
George: You see we have been teaching exactly that. When we say totality of symptoms, it is a resonance. We are trying to match the resonance of the person – how he resonates. It is much more subtle than dry symptomatology. It is so much more subtle. And the more we go into the heart of a person, the more we are drawing closer. Here we had enough information to go into the heart. What happens when we don’t have enough knowledge of materia medica and you are comparing… do not get disappointed from the cases I am going to give you. You will find no remedy at all, but don’t get disappointed. When Bill was in Athens and I would give him a study case every day, he hardly ever found the remedy. But I was giving him all cases like that, where he had to think. He had to learn to think. When we came here, he never had a failure because he had learned to think. And do not get disappointed when you do not get the remedy. What I want to transmit to you is not the case, it is the way of thinking. Sometimes in another case we shall rely completely on the keynote – one keynote-that is all we have. One keynote and perhaps worse cold and worse heat. Now with this keynote, which is the remedy? We have no more symptomatology. Here it was interesting in this case because the essence was hidden behind information which was sometimes misleading. The desire for ice-cream, the sleeping on the right side, palpitations, but again where is the first and where is the essence of Phos.? So this woman got Arg-n. 1m. You could give 10m. There is not much difference that you can justify.
Response: He really thought it was Phos.
George: The woman had come in June 1977. She phoned on April 10, 1978. She came once and she was perfectly well. On April 10 of the next year, ten months later exactly, she telephoned to say that she had a relapse. A repetition of the remedy was given at that time, 1m by phone. The case was not taken again. Then in May she came for a consultation. She first came on the 14th of June and now she came for a second consultation on the 30th of June. She stated that she had been having dental work for one month and she now complained about her nails which were very brittle. The symptoms now became very prominent – brittleness. This was underlined twice. She said that she was better with everything else. Claustrophobia was better. She did not check for robbers any more. She woke up in the night sometimes. The heaviness in the chest was less. The irritability and anxiety were much less. She said the hair was better, but I don’t remember her mentioning anything about the hair before. Most probably the hair was falling out.
She noticed that her hair got better during treatment. Only before menses did she have tachycardia and sleeplessness. She is not sighing any more. She doesn’t say anything about the darkness but she has lost her fear of robbers. So she has this picture. What is your prescription?
Essentially she has nothing. She just asked me if she could pay some visits, but the only complaint she really had was that the nails were brittle.
Question: Did she know that dental work would interrupt her remedy?
Question: What about her energy level?
George: Everything was much better. The very fact that she did not even come for a second consultation indicated this, until she had had a relapse.
Question: What about the dental work? What is your position on that?
George: Dental work can antidote the homoeopathic treatment. Most of the time this is when they give an injection to anaesthetize the tooth, as well as the disinfectant which they use which comes from clove oil.
Question: The drilling is not the factor then?
George: Not the drilling. The drilling does not. If they drill and they fill it, that is okay. There is no problem. But the injections and the putting on of that oil of cloves is a problem. They use it a lot of the time in Greece. And I have seen relapses. One has to be very careful. Also with the treatment of the gums – gingivitis – you may have a relapse.
Question: Peggy asked Whitmont about whether he had seen antidoting by dental work and he said that he always gave Arn. to his patients and then he did not antidote. This was given to counteract the shock to the system.
George: I don’t believe in that and I don’t see any logic behind it. There are many ideas. Give Arn. before going to the dentist; give Gels. before going; give this, do that; give Chin. They have devised different ideas and they give these, but I do not believe these ideas. I believe that you should leave the patient alone. If he can withstand the treatment, that is okay. If he cannot and there is a relapse, you will have to treat him. If there is a relapse, but there is many times no relapse.
Now there is a continuation. We have not finished the case.
This lady now comes again on February 22nd of the following year, and she says that, “For 20 days after grief she is not feeling well, especially in the afternoon after 5 p.m. She wakes up from an afternoon sleep.” She is worse after 5 p.m. , after waking. She has a tachycardia and she feels great tiredness. She has to put a lot of effort out to accomplish even the least amount of work. When she says that she has much anxiety or she is irritable, she has a kind of itching on the right leg. Again she is impatient and she has anxiety. She is excitable continuously. Again her sleep is not good and it does not refresh her. She has headaches in the occiput and temples, especially after 11 a.m. and it is better with pressure (underlined once).
She again has leucorrhoea which is offensive, worse before and after menses. The last menses came 5 days earlier, with pain in the uterus described as “stitching pain”. The whole menses came with great tiredness (underlined thrice) Generally over the last 15 days she has been feeling weak and dull as “if she was losing herself”. This is worse in the morning in her office. There was bloating of the abdomen and rumbling (underlined once) and nausea, especially between 6 and 7 p.m. There is a pain in the abdomen with pressure and this is worse with sweets. She had a sedimentation rate which was 50 the first hour. The hair again had become oily and the nails were brittle, but she feels the cold now, (underlined once). She desires sweets (underlined twice), fruits (once), aversion to fat (twice), and aversion to milk (once). Lately she had had a dry mouth and considerable thirst. There was constipation without urgency. The claustrophobia was again present, but was much less. She had a tired back. The feet smelled offensive from sweat with a putrid quality (underlined once). There was pain in the right shoulder joint. The doctor had suggested Sel.
Question: Was she extroverted?
George: It does not indicate one way or the other.
The underlining with tiredness is three times, with rumbling (once), vertigo (once), dullness. Headache is underlined once, worse with cold (once). The underlining is much less, because generally the suffering is much less than before. Does anyone have the complementary substance?
Answer: Merc., Puls., Sep., Spig., Spong., Sil.
Response: I would wait a month.
George: The pain seems to be quite bad in the right shoulder. The sedimentation rate is quite high and I do not know why? 50 in the first hour. That is strange. The tiredness is very great (underlined 3 times). There is no psychological state of Arg-n. anymore. We do not have anymore the psychological state of the Arg-n. essence. She is feeling the cold. Remember this is a hot person, bothered by the heat. You see the changes are quite strong. the symptomatology went away from the mental/emotional state. Where is this now? She is complaining about the back, the shoulder joint and physical weakness as well as the headache. She said that 20 days ago she had had a great grief. Since then she had not felt well. There was a kind of lowering of the health generally and then the appearance of different symptomatology, the most prominent of which is the great physical weakness, headaches, shoulder joint and low back pain, feeling the cold, and she says that she feels “an excitement inside”, which is constant. In this case it is interesting to note that if you get a case so far apart, after 8 months, you will not usually get the time of aggravation because she has forgotten it. She may not remember that she had the aggravation and on which date. It is not mentioned here for that reason I believe.
Question: Her general condition is worse at 5 o’clock?
George: The rumbling? She wakes up early in the afternoon at 5 and feels better, but the rumbling is between 6 and 7. The information states that she is still open and this is underlined. It seems to be with her husband because later on she will say that he almost divorced him. So by grief we do not necessarily mean that she suffered a loss, it could be vexation.
Response: I would still wait.
George: Why? Here her case is actually much more difficult than the first time, because the suffering is not intense and you have very little to go by. If you let her wait, she will deteriorate more and more, and then, perhaps after five months of suffering you could give the right remedy with more certainty. She needs a remedy. The constitution has changed. Arg-n. is finished and now she needs another remedy which will have to be found sometime. If you don’t give her that remedy now, she will come next time and ask for a remedy.
Response: Unless she happens to be better without a remedy.
George: That is doubtful. It you cannot find the remedy, the best thing is to give a placebo.
Response: I think it is better to give a placebo than to take a stab at a case and cause a relapse.
George: The remedy is difficult to find, and it is acceptable to give a placebo and wait for another month. But what we see here is complaints about her nails on the second visit, which had become worse. When she came after a year, she complained about the brittle nails. We did not give a remedy at the time. Now she complains about tiredness and some arthritic symptoms, with pain in the back and in the shoulder and headaches, as well as weakness. Then we have to find a remedy which is for cold, aversion to fat (twice), desires sweets (twice). This would be a remedy which has cold feet and a weak back which is an arthritic remedy. Remember that the feet have an offensive sweat in spite of the fact that the feet are cold. Who said Calc.? Why?
Response: Because of the weakness before menses, the coldness, the sweet craving, weak back, feet cold with offensive sweating.
Question: It states that the symptoms are worse at 5 o’clock in the evening when she wakes. Is that a time aggravation or worse after afternoon sleep?
George: There is constipation and thirst is more.
Question: She said that she had pain with menses. Was this heavier?
George: No, she said it came five days earlier with “stitching pains” in the uterus. The remedy is Calc.?
Question: If she had not had the aversion to fat and the craving for sweets, would you have gone to Sil.?
George: In order to give Sil. in that case, I would want the aggravation from cold to be much more severe. Sil. is very cold, especially with drafts.
I see the weakness in the back, the arthritic condition. I see the cold feet and the perspiring feet in spite of being cold. The desire for sweets has remained underlined twice. It has gone down, but it has remained strong. Then there is the irritability and the excitement. This syndrome would indicate Calc. It is fairly clear to me, but I understand that it is not clear to you.
Question: What is against Calc.?
George: Not much. Why do we prescribe Calc.? Because we take all the things and we put them together. Nothing is against Calc. and the whole picture, as you put it together, is Calc., especially the weakness. This is very important – the weak back. She is not strong enough to stand; that is a weak back. That is Calc. They feel the weakness when they stand.
Question: Is that similar to the weak back of Sil.?
George: No. Sil. does not have that weakness. Sulph. is worse on standing, but there is no weakness, especially in the back. We are taking the arthritic tendency which the patient has which most probably is connected with the calcium picture, cold feet, perspiring feet, all these, and this put together creates the picture of Calc. The best remedy that covers the symptomatology is Calc.
Question: This is another good example of the difference between the essence and the data. You can make a case on data from the others, but the tiredness is so prominent, and that is the essence of Calc.
George: She stayed well. She was given 200. After eight months she again had a great grief which almost ended in divorce. During this fighting with her husband, she took Valium and drank coffee. Now again she had a heavy feeling in the chest, tachycardia, inner anxiety, irritability, water as before, tiredness (underlined once), but not as much as before. There was some falling out of the hair and the desire for sweets was now underlined once. She developed a desire for yoghurt (not underlined). The thirst had become prominent (underlined once). She had anxiety (underlined twice). She again had constipation. Sleep does not relieve her symptoms. It does not say whether she is warm or cold. The grief has been since one month.
Question: Was it over now? Was this resolved? Or was she still in the middle of it?
George: She says, “I reached a point where I almost divorced my husband.” What is your remedy?
George: Here we made a mistake. Here Ign. should have been prescribed because you don’t have an underlying constitutional condition now. You have a grief, heaviness of the chest and tiredness. If you give a remedy it must be Ign. But since she had done so well on the Calc., the doctor repeated this. And what happens? She comes back after a month and says, “There is no change”.
“The tachycardia is there, along with anxiety, heaviness in the chest. Of course the problems are not resolved yet. I am still under stress.” She was sighing (underlined twice). She had been through and still was in grief. She had rumbling and nausea. She had tiredness in the evening with continuous constipation. Thirst is normal. She had constipation and distension. Sleep does not refresh her (not underlined). What are we going to do now? Now we give Ign. You see the Calc. did nothing and by now had made the case a little worse. There are now more symptoms underlined. Ign. 1m was given. She came back later to say that she had been very well psychologically after the Ign. She had no tachycardia or anxiety, but for 15 days she had had bloating of the stomach associated with pain. This was worse on pressing or touching. There was burning of the stomach. The liquids are burning. Irritation was worse in the mornings between 9 and 10 and in the evenings between 5 and 7. She feels the cold (underlined twice, perhaps three times). Desires sweets (underlined twice). Again she has a drawing pain in the stomach, constipation with urging and no effect, and her stools were like sheep-dung. That was on the 23rd of January.
Question: How long after the Ign. was that?
George: The date of the Ign. was November 22nd. This was one remedy in a small potency. You see now that the trouble has gone into the stomach. The grief that she went through – after going through the mental plane – localized in the stomach primarily. Palpitations are prominent (underlined twice).
Question: Did you say her feet are cold now?
George: Yes, the feet are cold. You have to differentiate between Lyc. and Nux-v. here. We have some symptoms each and we want to differentiate between the two. Which one and for what reason?
Answer: It is too chilly for Lyc. I vote Nux-v.
Response: I would say Nux-v. because the new symptom is the type of constipation. Lyc. follows Calc., however.
George: The fact that the disease somatizes and goes into the stomach indicates both remedies. Both can be indicated in digestive disorders, predominantly a disorder of drugs. There is a reason in this case why you should not give Nux-v.- a definite reason where you should avoid this remedy.
Question: The strong desire for sleep?
George: NUX-V. IS INIMICAL TO IGN. WHEN WE GIVE IGN. AND IT DOES NOT WORK, WE DO NOT GIVE NUX-V. If one gives Nux-v. and it works, we should NOT follow it with Ign. Again, the time and the duration goes with Lyc. The worst cold is Lyc. This is one of the remedies that you should be careful of. If one has acted, do not give the other.
Question: I did not think you believed in that set of relationships.
George: I said that I did some experiments.
I said that after Calc. in a case I had given Sulph., because Kent 2 says: Sulph., Calc., Lyc. So I had given Calc. and then I went back and I gave Sulph. I had a relapse of the case. This is what you remember.
Question: You also said that you would not hesitate to begin a case with Lyc. Clarke 3 says very strongly that he would never do that.
George: I have started many cases with Lyc. – many cases. I would give 200. Some say do not give 200 because it produces a great aggravation. If you have a great aggravation that is the best.
Question: You have said that if a remedy image is really clear and it seems to violate the law, you would rather give the remedy than follow the law.
George: Yes, that is true.
Question: Does it make any difference if there is a longer time-span between those two-like a year instead of two months?
George: Yes. I would think that that made a difference. I would hesitate very much unless it is absolutely clear in the case. If it is very clearly indicated I will try it. I tried it with Sulph. That was clear and I gave it. I spoiled the case in that instance. I had a terrible job bringing it about again. This was a cholera case where we had battled for six to nine months and the case was going nicely. You become eager to progress more and clear the case. You think now that it is Sulph. You see, I went to Calc. and it acted, now there is a remedy which you can take and be well. You take it and back you go again.
Response: I gave Lyc. after Sulph. with no problem.
George: You must be careful of that. They are very similar and you might spoil the case.
Response: In Iris’s case it went Calc.-Sulph. and it worked.
Question: How much importance is placed on the fact that those remedies are complementary and Nux-v. isn’t in there?
George: Which remedies? Nux-v., Lyc.?
Answer: Well, Nux-v. isn’t in the complementary remedies. What then?
George: Oh, I see. This is complementary to Arg-n.
Question: And that is all past?
George: This is Arg-n.’s complementary. We are not talking about this phase now. This is gone. We have gone to Ign. After Calc. Ign. reacted. Then from some grief she had she developed gastritis and we gave one dose of Lyc. 30.
Question: Why the 30th potency in this case?
George: Because the trouble is not so serious. The remedy is not absolutely clear. It is better that we go low. If this is the right remedy, it will touch it. Most of the work had been done by Arg-n. and then Calc., so this woman has really changed. She is another person altogether. She comes now with the gastritis and it is nothing in comparison to how she was before.
I might even have given 12 potency because the picture is not so frightening now and she is not so sick. It is not very clear, and so we had better be careful and not spoil the case.
Question: Since it was only 15 days, waiting would seem to be the proper thing.
Question: Did you see it more or less as acute?
George: I saw it as a continuation of the grief. The grief was quite a lot and it finally went into the stomach. I do not think she would have recovered without the remedy. If you do not give a remedy here, and she is disappointed at that stage, she may go and take drugs such as antacids with some aggravation of the constipation. Then we do not know where it is going to end. So it is better to take the Lyc. 30.
Question: Why does this remind you of Nux-v.? I see Lyc. more clearly.
George: I just said…
Question: No, I said why would it also be Nux-v.?
George: Why COULD it also be Nux-v.? That is what I was explaining.
Response: I think what is being asked is that you said that it was a dilemma between Nux-v. and Lyc. Nux-v. is not so clear.
George: Everybody saw Lyc., so that is okay. I could see Nux-v. in that case, because someone mentioned it and I said let’s differentiate between the two. I have seen them work and that is why I took Nux-v., to differentiate.
Question: I find that invariably there is an extreme milk-intolerance which causes diarrhoea and a certain type of feeling in the nose. There is extreme irritability from sudden noises. There is invariably the sensitivity to the direct sun and at the same time they are chilly people. Mentally and emotionally I find them to be very walled off and very much like Nat-m. except maybe more so. They are more walled off and more frightened and timid, more sensitive, tending to be all easily depressed. The description on page 42 in the Materia Medica of Kent 4 was something that I found so clear that I was able to use it. (Nat-c.)