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Finding a remedy for this case...
Dear Sameer and others,I am doing a case and would like some feedback on choosing a remedy.
I have already chosen a remedy for this patient and gave them the first dose yesterday, but I'd like thoughts and confirmation about the remedy.
Patient is a male aged 62. He is a scientist/professor who is extremely accomplished. His constitutional nature is Coleric with some Saguine, though he also has some Aritable traits. He is mostly lacking in the phlematic temperrment and needs other people to tell him when they have strong emotions as he doesn't know. He has tan/blond hair with a bit of grey. He is of medium height and of slender/strong build.
He will often get angry if he sees someone doing something technically incorrect, such as carrying an equiptment in the wrong manner or not handling a practical matter in the way he would. He will get angry and yell for a few minutes, after which he will become calm, and act is if nothing has happened. When asked about this he said that he would never do this with anyone who he does not care about. He says that he gets the urge to do this at work, but doesn't because it would not be professional.
For this I used the rubric:
MIND; ANGER, irascibility; tendency; alternating with; repentance, quick (7) : anan., croc., lyss., mez., olnd., sulph., vinc.
For the last 20 years he has drank several cups of coffee per day, and will do work while he is drinking his coffee.
He has few friends and is quite an intellectual loner. He has several hobbies and projects which he obsesses over and which are always exceptionally successful.
He is a rugged type and enjoys activities such as camping and being outdoors and looks down upon luxurious activities.
He has published several books and thousands of pages of esteemed articles.
He often takes naps and rests during the day, usually for only an hour or so.
He has always been healthy and has little to report about his health. He had many cases of poison ivy about 20 years ago which were treated with calamine lotion. (I don't think that Poison Ivy is suppression?)
He tends to get down about his professional projects and his financial situation. He expresses a great deal of frustration with his practical affairs. He always seems to be very pessimistic due to his financial situation (which is normal) and the status of his projects.
He is extremely critical and rarely encouraging of others even when he tries hard to be.
He sometimes does not like to talk. Is often argumentative, and when prodded about things can postpone decisions for a long time.
He complains of a sore back. He goes to get massages once per week and also goes to a chiropractor and has done this for years.
There is not much medical history since he has almost always been well.
He shows indications of inherited syphilis (obsession in projects and work) and sycosis (his face, hands, and body is covered in brown spots and warts).
He is constantly scratching his hands, which are often dry, and has done this for a long time.
His wife reports that he hates warm weather and that he is bothered even more by humidity.
He has a fear of the sight of blood, and has a fear of hypodermic needles, having his blood drawn at a doctors, and the constricting band put on at a doctors. He says that his is psychological due to the trauma of seeing his mother in the hospital as a child.
He also has a fear of public speaking, and attributes this to being a child when he was asked to read before the class while sick and on antibiotics. He felt sick and passed out and was made fun of. He still does public presentations yearly.
He has mentioned waking up in the middle of the night due to nightmares every hour. He has also mentioned bad dreams. It's not clear if these are recent symptoms.
Thanks...
BeginningHomeopath on 2008-09-28
This is just a forum. Assume posts are not from medical professionals.
Sulphur :)
sameervermani last decade
Good morning, Sameer!
What time zone are you on?
Here is some additional information on the mentals.
This patient has no religious affections or fancies. They are anything but a philosopher. He cannot tolerate theory, only scientific and research data. He publishes in a hard science area, and is a researcher in sciences. He has no ability to tolerate soft-sciences or more theoretical or philosophical material. He is never hasty. He does everything in a tried and true method.
Technically he extremely capable and runs a laboratory and supervises many people very carefully.
He can be easy going as long as everything technical is done absolutely perfectly. He is primarily coleric, with a distant secondary element of the saguine.
The described anger occurs for 5 minutes at a time. Other than that he is never angry and is often accepting providing that one is careful in his technical area. He is never ill-humored or peevish. He is never restless or lazy, hasty, or forgetful. He is also not self-absorbed. I have never seen this patient even slightly egotistical or religious in any way. He is not hypochondrical at all.
He can be very pessimistic and discouraged, though I have never seen him weep. I have never seen him cheerful or optimistic. He can be extremely fault-finding.
What time zone are you on?
Here is some additional information on the mentals.
This patient has no religious affections or fancies. They are anything but a philosopher. He cannot tolerate theory, only scientific and research data. He publishes in a hard science area, and is a researcher in sciences. He has no ability to tolerate soft-sciences or more theoretical or philosophical material. He is never hasty. He does everything in a tried and true method.
Technically he extremely capable and runs a laboratory and supervises many people very carefully.
He can be easy going as long as everything technical is done absolutely perfectly. He is primarily coleric, with a distant secondary element of the saguine.
The described anger occurs for 5 minutes at a time. Other than that he is never angry and is often accepting providing that one is careful in his technical area. He is never ill-humored or peevish. He is never restless or lazy, hasty, or forgetful. He is also not self-absorbed. I have never seen this patient even slightly egotistical or religious in any way. He is not hypochondrical at all.
He can be very pessimistic and discouraged, though I have never seen him weep. I have never seen him cheerful or optimistic. He can be extremely fault-finding.
BeginningHomeopath last decade
I have often seen this patient rub their skin, particularly on his hands, though they report not having any euptions on their skin in many years.
BeginningHomeopath last decade
His hands are dry, covered in bumps, warts and hard, thick, dry skin. He has many sycotic bumps and warts, particularly on his face and hands. He has sycotic brown spots all over his torso and back.
He reports that he has never had sycosis. His father had even more of these warts than he has. It is not possible to know if his father ever had sycosis. His father died of a heart attack and his mother died of lung cancer when he was a teenager, which may have been a never well since event.
He reports that he has never had sycosis. His father had even more of these warts than he has. It is not possible to know if his father ever had sycosis. His father died of a heart attack and his mother died of lung cancer when he was a teenager, which may have been a never well since event.
BeginningHomeopath last decade
sameervermani last decade
All of his work and publishing are extremely technical in a hard science area. He has done thousands of scientific experiments and is meticulous.
Meticulous is a good way to describe everything about him.
Meticulous is a good way to describe everything about him.
BeginningHomeopath last decade
I'm in the US, but I keep late hours.
What do you think about the additional information here. I will write up the remedy I have been thinking about and that I gave him and post it.
What do you think about the additional information here. I will write up the remedy I have been thinking about and that I gave him and post it.
BeginningHomeopath last decade
One other symptom I gave special attention to. He will often be extremely afraid that something bad will happen. If there is a glass on the table, that looks like it might get bumped over, he will be especially concerned, far out of proportion of the actual situation. He is especially worried about any bad thing that could happen.
BeginningHomeopath last decade
BeginningHomeopath last decade
I identified this pateint's remedy as Mez, and gave a test dose of 30c in water last night. Here is my rational for identifying Mez.
MIND; ANGER, irascibility; tendency; alternating with; repentance, quick (7) : anan., croc., lyss., mez., olnd., sulph., vinc.
mind; emotions, feelings, attitude, disposition; anger; alternating with quick repentance; Sulph, Mez, and Croc.
Boenninghausen's MM confirms napping during the day and that he wakes to nightmares in the middle of the night.
Patient's wife describes him as not liking heat or humidity, which Kent also identifies.
'The Mez. patient is sensitive to warm air as far as the skin and. eruptions are concerned, but very sensitive to damp or cold weather ' (Kent)
Comments from patient's wife: Says he would much rather be cold than hot. 'He hate's hot as it makes him uncomfortable. The minute it's hot out he doesn't like it. He doesn't like humidity either. Sometimes he doesn't like to talk.'
Will sometimes will also nap in the afternoon alone. This is also a symptom of Mez.
From Lippe's MM, there are some other similar symptoms.
Aversion to talk, it seems to him to be hard work to utter one word.
Disposed to reproach others or to quarrel.
Irresolute.
Rheumatic pains in the muscles of the shoulder-blade ; they feel tense and swollen, and prevent motion.
Awakens after midnight, from vivid dreams and with night-mare.
Brownish spots on the skin (Ant. cr., Carb. veg., Lyc., Mezer., Nit-ac., Phosph., Sepia). KENT
The outer surfaces of the body are in a constant state of irritation; nervous feelings, biting, tingling, itching, changing place from scratching. (Kent)
Even when there is nothing to be seen, there is violent itching and the patient rubs and scratches until the part becomes raw and then burns (Kent)
changing place after scratching, ESPECIALLY WHEN ASSOCIATED WITH NO VISIBLE CAUSE. (Kent)
Religious or financial melancholy; melancholy which shapes itself upon the patient's business; indifference to everybody and everything; irritable; thought is difficult; memory weak; absent minded; has no rest when alone, yet averse to talking. Insanity with melancholy, sadness, and a history of eruptions that have called for Mez.
(Kent)
The Mez. patient is sensitive to warm air as far as the skin and. eruptions are concerned, but very sensitive to damp or cold weather as to the neuralgias. After the eruptions have given place to internal manifestations, the patient is chilly, sensitive to the changes of the weather, worse in stormy weather; worse after a bath, because he takes cold and his internal complaints are aggravated. The eruptions are aggravated after washing. (Kent)
The face is sickly, full of ulcers, old scars, boils, etc. (Kent)
Sensation of goneness, fear, apprehension, faintness in the stomach, as if something would happen; every shock, pain and hearing bad news, cause this apprehensive, hungry, faint, weak, all-gone feeling in the pit of the stomach. It comes on when the door-bell rings, if the patient is expecting the postman, while waiting at the depot for the arrival of a friend or the departure of the cars (Kent)
MIND; ANGER, irascibility; tendency; alternating with; repentance, quick (7) : anan., croc., lyss., mez., olnd., sulph., vinc.
mind; emotions, feelings, attitude, disposition; anger; alternating with quick repentance; Sulph, Mez, and Croc.
Boenninghausen's MM confirms napping during the day and that he wakes to nightmares in the middle of the night.
Patient's wife describes him as not liking heat or humidity, which Kent also identifies.
'The Mez. patient is sensitive to warm air as far as the skin and. eruptions are concerned, but very sensitive to damp or cold weather ' (Kent)
Comments from patient's wife: Says he would much rather be cold than hot. 'He hate's hot as it makes him uncomfortable. The minute it's hot out he doesn't like it. He doesn't like humidity either. Sometimes he doesn't like to talk.'
Will sometimes will also nap in the afternoon alone. This is also a symptom of Mez.
From Lippe's MM, there are some other similar symptoms.
Aversion to talk, it seems to him to be hard work to utter one word.
Disposed to reproach others or to quarrel.
Irresolute.
Rheumatic pains in the muscles of the shoulder-blade ; they feel tense and swollen, and prevent motion.
Awakens after midnight, from vivid dreams and with night-mare.
Brownish spots on the skin (Ant. cr., Carb. veg., Lyc., Mezer., Nit-ac., Phosph., Sepia). KENT
The outer surfaces of the body are in a constant state of irritation; nervous feelings, biting, tingling, itching, changing place from scratching. (Kent)
Even when there is nothing to be seen, there is violent itching and the patient rubs and scratches until the part becomes raw and then burns (Kent)
changing place after scratching, ESPECIALLY WHEN ASSOCIATED WITH NO VISIBLE CAUSE. (Kent)
Religious or financial melancholy; melancholy which shapes itself upon the patient's business; indifference to everybody and everything; irritable; thought is difficult; memory weak; absent minded; has no rest when alone, yet averse to talking. Insanity with melancholy, sadness, and a history of eruptions that have called for Mez.
(Kent)
The Mez. patient is sensitive to warm air as far as the skin and. eruptions are concerned, but very sensitive to damp or cold weather as to the neuralgias. After the eruptions have given place to internal manifestations, the patient is chilly, sensitive to the changes of the weather, worse in stormy weather; worse after a bath, because he takes cold and his internal complaints are aggravated. The eruptions are aggravated after washing. (Kent)
The face is sickly, full of ulcers, old scars, boils, etc. (Kent)
Sensation of goneness, fear, apprehension, faintness in the stomach, as if something would happen; every shock, pain and hearing bad news, cause this apprehensive, hungry, faint, weak, all-gone feeling in the pit of the stomach. It comes on when the door-bell rings, if the patient is expecting the postman, while waiting at the depot for the arrival of a friend or the departure of the cars (Kent)
BeginningHomeopath last decade
Hmm.. interesting, but you did not mention about the apprehension in the stomach in the patient's description.
I read it more as an anxious cautiousness.
Miasmatically, I think this case is syphilis on a psoric background. I see no sycosis there at all. Although, there might be something tubercular going on there, but we will see. Mezerium indeed is one of the leading anti-syphilitic medicines, so I would be interested in knowing how the patient responded to it.
Sameer
I read it more as an anxious cautiousness.
Miasmatically, I think this case is syphilis on a psoric background. I see no sycosis there at all. Although, there might be something tubercular going on there, but we will see. Mezerium indeed is one of the leading anti-syphilitic medicines, so I would be interested in knowing how the patient responded to it.
Sameer
sameervermani last decade
Sameer,
Thank you for your comments. Perhaps you can help me particularly with dosing this patient as that is an area I am lacking.
Actually, Kent says about the stomach. The patient has pain on hearing bad news, and fear upon every potential bit of bad news as Kent describes. The patient wouldn't confirm anything about the stomach. As soon as I asked any specific follow up questions this patient disagreed with it, so I had to ask open ended questions and just let the patient answer.
I agree that this is a syphilis case with psora. However there are an excess of sycotic warts on the patients hands, face, and body. His body is also covered in brown sycotic spots.
I gave the patient 30c (1 30 pellet dissolved in 8oz of water, one drop moved to a 8oz dilution glass and one drop taken as the dose). The patient wanted a small dose as he was afraid of a 'homeopathic aggravation'. As expected, there was no noticeable effect after taking the dose or this morning.
What should I do?
Thank you for your comments. Perhaps you can help me particularly with dosing this patient as that is an area I am lacking.
Actually, Kent says about the stomach. The patient has pain on hearing bad news, and fear upon every potential bit of bad news as Kent describes. The patient wouldn't confirm anything about the stomach. As soon as I asked any specific follow up questions this patient disagreed with it, so I had to ask open ended questions and just let the patient answer.
I agree that this is a syphilis case with psora. However there are an excess of sycotic warts on the patients hands, face, and body. His body is also covered in brown sycotic spots.
I gave the patient 30c (1 30 pellet dissolved in 8oz of water, one drop moved to a 8oz dilution glass and one drop taken as the dose). The patient wanted a small dose as he was afraid of a 'homeopathic aggravation'. As expected, there was no noticeable effect after taking the dose or this morning.
What should I do?
BeginningHomeopath last decade
Hehe, afraid of homeopathic aggravation ;)
Wait for atleast 48 hours to see if there is any response.
In case there is none, do not succuss, and give him 1 spoon directly from the remedy bottle ONCE, and wait for 72 hours for the response. Any aggravation (highly unlikely) with this dose should be very short lived (at most 24-48 hours). If there is benefit, wait for one more week or longer if the improvement continues longer.
If and when the response comes to a halt, then, I would do a similar dose of 200c.
Sameer
Wait for atleast 48 hours to see if there is any response.
In case there is none, do not succuss, and give him 1 spoon directly from the remedy bottle ONCE, and wait for 72 hours for the response. Any aggravation (highly unlikely) with this dose should be very short lived (at most 24-48 hours). If there is benefit, wait for one more week or longer if the improvement continues longer.
If and when the response comes to a halt, then, I would do a similar dose of 200c.
Sameer
sameervermani last decade
Sameer,
Thanks. I have spent hours on each of these two cases we've discussed gathering information, looking into remedies, gathering more information, asking relatives for information, etc. I also have the advantage of seeing this patient on occasion, and have known him in person, and have photos, etc.
Are you satisfied that Mez is a good remedy in this case? I am not comfortable giving him a spoon directly from the remedy bottle with no dilution bottle. Would it be alright to give him one teaspoon from the dilution bottle?
Thanks. I have spent hours on each of these two cases we've discussed gathering information, looking into remedies, gathering more information, asking relatives for information, etc. I also have the advantage of seeing this patient on occasion, and have known him in person, and have photos, etc.
Are you satisfied that Mez is a good remedy in this case? I am not comfortable giving him a spoon directly from the remedy bottle with no dilution bottle. Would it be alright to give him one teaspoon from the dilution bottle?
BeginningHomeopath last decade
I think you are the best judge as far as the remedy is concerned, because you have the biggest advantage of having met the patient. Nothing can replace that. I am sure, you have come up with a remedy after some very good analysis.
I would go ahead with 1 spoon directly from the remedy bottle. I personally start with 3 quick doses, but if you want to be more conservative, start with one.
These are not LMs, that you need a dilution glass for every patient. In case of centesimals, it is mainly meant for hypersensitive patients only. And, he is not hypersensitive as is proved by the fact that there was no response to 1drop-1drop dose.People of average sensitivity will not even notice that dose.
Now what happens is this, people, most of them Dr. Luc's followers keep repeating 1/2 teaspoon from the remedy bottle in a dil glass - 1/2 teaspoon from the dil glass as dose, every 3 days or so and this will invariably produce accessory symptoms for the reasons I described in the other thread, and will never be as effective as a single stronger dose. I have personally tried this many a times (when I was experimenting), invariably with bad results. But, you can go ahead and try whatever you think is the best, as I am sure you will realize the same truth yourself.
You can see many of my cases on this website, not even 1 person has ever reacted badly to 1 teaspoon directly from the remedy bottle.
I would go ahead with 1 spoon directly from the remedy bottle. I personally start with 3 quick doses, but if you want to be more conservative, start with one.
These are not LMs, that you need a dilution glass for every patient. In case of centesimals, it is mainly meant for hypersensitive patients only. And, he is not hypersensitive as is proved by the fact that there was no response to 1drop-1drop dose.People of average sensitivity will not even notice that dose.
Now what happens is this, people, most of them Dr. Luc's followers keep repeating 1/2 teaspoon from the remedy bottle in a dil glass - 1/2 teaspoon from the dil glass as dose, every 3 days or so and this will invariably produce accessory symptoms for the reasons I described in the other thread, and will never be as effective as a single stronger dose. I have personally tried this many a times (when I was experimenting), invariably with bad results. But, you can go ahead and try whatever you think is the best, as I am sure you will realize the same truth yourself.
You can see many of my cases on this website, not even 1 person has ever reacted badly to 1 teaspoon directly from the remedy bottle.
sameervermani last decade
The patient has work for the next week and wanted to take the remedy tonight. I had him take 1/2 teaspoon from the 8oz remedy bottle (which contained 1 pellet of 30c Mez) and put it in the 8oz dilution bottle and had him take one half teaspoon of that.
I am again erring on the side of a lower dose because he would rather not have an aggravation.
He reported noticing no difference. At this point I'll simply wait for some time.
Thanks!
I am again erring on the side of a lower dose because he would rather not have an aggravation.
He reported noticing no difference. At this point I'll simply wait for some time.
Thanks!
BeginningHomeopath last decade
Since taking the dose, the patient is not aware of any change in feeling. He sounded much happier, healthier, and more optimistic than usual.
When asked if he had more vitality, he wasn't sure. Yet he commented that he had lifted weights hard the night before, and had not napped that afternoon.
I think this is a good response.
Yes. I agree that this case is syphilitic and psora.
I think that the warts and brown spots also indicate some sycosis.
When asked if he had more vitality, he wasn't sure. Yet he commented that he had lifted weights hard the night before, and had not napped that afternoon.
I think this is a good response.
Yes. I agree that this case is syphilitic and psora.
I think that the warts and brown spots also indicate some sycosis.
BeginningHomeopath last decade
Sameer,
I gave this patient 1/2 teaspoon from the 8oz remedy bottle (which contained 1 pellet of 30c Mez) and put it in the 8oz dilution bottle and had him take one half teaspoon of that.
How long should I wait before giving another dose? Also, what would you use as the next dose?
I gave this patient 1/2 teaspoon from the 8oz remedy bottle (which contained 1 pellet of 30c Mez) and put it in the 8oz dilution bottle and had him take one half teaspoon of that.
How long should I wait before giving another dose? Also, what would you use as the next dose?
BeginningHomeopath last decade
Beginning,
See this is the problem now with the small dose you gave. The dose was right in dynamization but too small in the amount. Now the temptation is to repeat the same small amplitude dose at a very very slight change in dynamization. The change in dynamization will be approx be 10/300, about 2~3 %, and although this is still lot better than what the change would be in a 200c but is far from ideal.
If you are only comfortable giving doses with dilution glasses, I suggest you move to the LM scale as soon as you are sure of the remedy. With the C scale, you will have to give 'some' weight to each dose because you cannot stay at any potency for too many number of doses. 6c or 3c are better in this regard, as they will take sucussions relatively well.
Also, when given centesimals, never under-estimate a minute dose, wait as long as patient keeps showing gradual improvement.
Do not repeat a dose unless needed. With 30c you might you might still get away with a couple of repetitions spaced by 5 days each.But with 200c, I would never repeat it once a response has started.
See this is the problem now with the small dose you gave. The dose was right in dynamization but too small in the amount. Now the temptation is to repeat the same small amplitude dose at a very very slight change in dynamization. The change in dynamization will be approx be 10/300, about 2~3 %, and although this is still lot better than what the change would be in a 200c but is far from ideal.
If you are only comfortable giving doses with dilution glasses, I suggest you move to the LM scale as soon as you are sure of the remedy. With the C scale, you will have to give 'some' weight to each dose because you cannot stay at any potency for too many number of doses. 6c or 3c are better in this regard, as they will take sucussions relatively well.
Also, when given centesimals, never under-estimate a minute dose, wait as long as patient keeps showing gradual improvement.
Do not repeat a dose unless needed. With 30c you might you might still get away with a couple of repetitions spaced by 5 days each.But with 200c, I would never repeat it once a response has started.
sameervermani last decade
'You can see many of my cases on this website, not even 1 person has ever reacted badly to 1 teaspoon directly from the remedy bottle.'
If so, then when if ever does one need a dilution glass?
If so, then when if ever does one need a dilution glass?
BeginningHomeopath last decade
sameervermani last decade
I am learning much about homeopathy from this forum, much of which contradicts things I've read from prominent homeopaths elsewhere. Particularly about dosing, which is the area I am most in need of improvement.
Hahnemann mentions the use of a dilution glass or several dilution glasses in the Organon. I'm sure he must have used them for a reason.
Do you use dilution glasses much with LMs?
Also, how do you know if you should start a case on LMs 'vs C potency?
Hahnemann mentions the use of a dilution glass or several dilution glasses in the Organon. I'm sure he must have used them for a reason.
Do you use dilution glasses much with LMs?
Also, how do you know if you should start a case on LMs 'vs C potency?
BeginningHomeopath last decade
Let me ask another beginner's question.
I have been getting and using the 100c potency remedies as a medium step between 30c and 200c. I wonder why there aren't remedies between 200c and 1m.
Does anyone else use 100c remedies?
I have been getting and using the 100c potency remedies as a medium step between 30c and 200c. I wonder why there aren't remedies between 200c and 1m.
Does anyone else use 100c remedies?
BeginningHomeopath last decade
Dilution glasses are a MUST for LMs, you can never dose an LM directly from a remedy bottle unless you are using olfaction.
There is a reason why the 5th edition gave way to the 6th edition of the organon which without doubt is the most consummate work, and that is because centesimals do not bear 'repetition to speed up cure' well unless you are limiting yourself to low potencies like 3 , 6, 12 or at most 30.
There is a reason why the 5th edition gave way to the 6th edition of the organon which without doubt is the most consummate work, and that is because centesimals do not bear 'repetition to speed up cure' well unless you are limiting yourself to low potencies like 3 , 6, 12 or at most 30.
sameervermani last decade
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