When prescribing in rural clinics, getting feedback about the action of a remedy is not always easy. People generally only come when they need to. Others are nomads who may not be around next time. Therefore, some of the cases are more anecdotal in nature. However, they still example the process of taking cases in villages in Ghana, as well as in urban clinics.
One person came to the clinic in the country with excruciating pain in the rectum, forcing him to bend double. It came on when he strained for stool and since then has been unable to go. The pain is stitching and is felt in the rectum. At its worst he was rolling in pain on the ground. I gave Colocynthis 1M. After taking the remedy he had a slightly bloody stool and some relief. We suspected he had piles but there was no sign of that. He had a feeling as if his anus was becoming prolapsed with the pain. In the morning, I spoke to him again. He slept OK in the night but now is still in pain, which is worse when he feels the need to defecate. He still can’t go again. The pain is still there, but not so bad. I felt that the remedy may have taken the edge of the case, but not gone all the way. All I know of the person is that he is a soft spoken, quite gentle young man. He had apparently been beaten a lot as a youngster by his teachers and hence is quite nervous at times if challenged. So I gave him Staphysagria in 200C. Soon after he began to feel much better and he had a normal stool later that day.
In this case, I simply tried to get a little more information to help the analysis. We know that Colocynthis and Staphysagria share certain mental and physical characteristics, and so when a little background information was given and a few observations were made, it gave me enough details to prescribe on. Even in the West or in more urban situations, one can still prescribe like this. There isn’t always the need to go into an inordinate amount of detail to find a remedy.
Notes: Colocynthis is a remedy made from bitter cucumber and is in the Cucurbitaceae botanical family. It is a remedy for all kinds of colic and spasmodic pains, whether in the digestive tract or the nerves. Pains are mostly spasming with great contractions and cutting. They often make the person double up with pain. Pains can come on after being made angry or indignant. Staphysagria is made from a plant called Stavesacre and is in the Ranunculaceae botanical family. It shares many symptoms with Colocynthis but is particularly useful in any case where strong emotions like grief, indignation, humiliation have been suppressed, especially for long periods of time, leading to many physical symptoms developing, including abdominal cramping and spasms.
My young neighbor’s mother was not well so I went to see her. She hasn’t been able to go to market for 2 out of 3 days. She is just sitting there, saying she is having a headache, some pains in the body and fever. It is hard to know if fever here is malaria or not without being tested. Often fevers are treated as malaria, even if it is not. In other words, all fevers are malaria. But one doesn’t want to leave the fever if it is malaria. All I can get out of her is that she has a pounding headache and she had a salty taste in the mouth. She had pain in the back, neck and chest. No cough, no apparent fever when I felt her head. The main thing is that she just seemed so sad, just sitting there. I had nothing else to go on so I gave her Natrum muriaticum 30C.
Again, this remedy choice is based on a few characteristic qualities. We know that Natrum muriaticum is a good remedy in malaria, especially in the chronic complications of benign malaria and especially when pounding headaches are part of the picture. The salty taste in the mouth is another confirmation and her demeanor with the obvious sadness also helps me make the decision. So based on the information I could get, Natrum muriaticum is the obvious choice.
Note: Natrum muriaticum is one of the most important homeopathic remedies. It is made from plain salt which has no specific medicinal powers. However, when prepared as a homeopathic remedy it becomes a very powerful remedy and used for a wide range of conditions, often to do an imbalance in the water distribution of the body, including the kidneys. Emotionally it is one of the most important remedies for long term grief and loss and is suited to people who are more introverted and sensitive and who find it hard to overcome emotional losses and grief.
I read a book on Africa called The Scramble for Africa by Thomas Pakenham, describing the colonial land grab for Africa in the late 1800’s and he described the fatalism around death that many Africans seemed to have then, that there is this inevitability to it and when faced with any illness, there is a tendency to simply lie back and wait to die. This may partly explain some of the reactions to HIV/AIDS in Africa when people simply stop eating and fade away. It could be a combination of the disease and the cultural/psychological attitude to it, including the mere stigma of being diagnosed with the disease, which can be a death sentence in and of itself. The idea that different cultures may have a different susceptibility and therefore different reaction to the same disease is an interesting subject and more work could be done on this.
One other case was an elderly man who complained of being unable to walk for more than 5 minutes as he gets a weak numb feeling in the right hip which extends down the leg accompanied by an aching pain. I asked him what the pain felt like and all he could say is that it was like being hit by something. I asked if anything else happened before this happened, and eventually he revealed that a little while before these symptoms began, a large brick fell on his toe, which went black and the nail eventually fell off. He felt as if he could lose the toe as it looked gangrenous. So based on this, I gave Arnica and after this Hypericum could be considered. Obviously Arnica is indicated for the etiology, the pain as if being struck and even the fear of it becoming gangrenous.
This case examples the importance of getting a clear etiology (cause) in a case. In many cases we saw, understanding etiology helped a lot in prescribing. Etiology could be either mental or physical but it underlined its significance and also reflected to me how often this is ignored in more chronic case taking when the whole constitutional/essence/core delusion perspective takes precedence.
Note: Arnica is a remedy in the Asteraceae or Compositae family. It is similar to the simple daisy found in many parts of the world. It is the first remedy in Homeopathy for all kinds of physical trauma and shock. It helps bruises and stiffness heal quickly and can be used for concussion and all sorts of injuries. Hypericum is called St. Johns Wort and is in the Hypericacea family. It is the first remedy for injuries to nerve rich parts, like the fingers and the spine including head injuries.
I am in the clinic of a Ghanaian homeopath in the capital Accra and we are seeing some patients. One 50-year old woman comes in who is terribly fat, not the soft fat of Calcarea carbonica but solid. She weighs about 230lbs and has a goiter. She has had it operated twice already, once back in 1988 after it first came on when pregnant and again four years ago. At first, she was given drugs and it got better but a year after her child was born, it began to get very big and grew inward, nearly blocking off her windpipe and she would have gasping respiration. It was operated on then but has since grown back. Even now, after the second operation, it is very noticeable. She said she has always been overweight, ever since a child, but now is getting worse. She has a variety of pains in the body, including her shoulders. She complains of mucus in the windpipe (larynx) which can make the voice go hoarse. She can cough it up and it’s thick, stringy. But when it´s bad, she can have a very bad cough which at times has gone on for a couple of months. She says she is feeling tired and weak, even after talking. She also complained of a stitching pain in her chest which goes up to her neck area. She has had it for a while and it comes and goes.
Her diet is not that great, mainly white rice and fish stew. She eats some other vegetables but not a huge amount. She has no particular weather affinity. She was given Calcarea carbonica, Thyroidinum and Ficus religiosa by the homeopath without success. I asked her a few more questions and she admitted (her husband confirming) that she used to get very easily irritated, almost everything would affect here. Her husband said that you would see it on her face which would be stern and serious, until the anger bursts out. She said she wants to work hard, but the push is not there now. She is very particular about how things are done and she wants it her own way. She is not diplomatic (her husband says). In the past when angry, she could throw things. I asked if there were any fears and she said that as she lives in Lagos, Nigeria, there is always fear. “You sleep with your eyes open,” she said. There is just tension in living there.
So I chose to give her Ferrum iodatum. I didn’t feel she was Calcarea carbonica. Her body type was much firmer than often seen in Calcarea and her mental picture, with the anger and the particular nature and intensity didn’t seem clear. Also, the way the anger would be held in until it bursts fits Ferrum nicely. However, the chronic mucus in the larynx and the intensity of the cough she had, along with the obvious thyroid affinity made me consider Ferrum iodatum. Sulphur could be considered here too.
This is a more constitutional type analysis, but even this much information was not that easy to get. It required some persistent questioning. But this case examples an analysis incorporating the key physical symptoms and pathology, along with physical/mental observations and some significant information on her personality and behavior. Based on this amount of information, a reasonable remedy choice can be made. Unfortunately I could not follow the case for very long and other remedies were then given by another homeopath. However, given the severity of the pathology, I would like to have stuck to this remedy for a number of months in order to see any significant change. Even though the information on the case is not as comprehensive as one would normally like to have in chronic prescribing, the balance of keynote physicals, pathological affinity and a few significant mental symptoms gave me a fair degree of confidence in the remedy chosen. Having sometimes only one shot and very limited possibilities to follow-up a case belongs to the African experience for a homeopath and made me include this case despite its unfinished nature.
Note: In homeopathy we take all kinds of information into account to find the correct remedy. The body shape, personality characteristics, food desires, weather preferences as well as the key physical symptoms are used to help find a remedy. In this case Ferrum was given, which is made from iron. People needing Ferrum are often very determined and resolute and easily angered. They persevere in life, but can feel as if they need to wear and emotional armor around them. Because she had particular problems in the thyroid gland, I added iodine, which is found in the compound Ferrum iodatum. Iodine is an essential factor in many thyroid conditions.