Aconit, Natrium sulphuricum, Fuzzy Impressions, Two Cases

Case One
Man, born 1969, salesman in a shop. First consultation: November 2001.

Main complaint: Strong fears and Anxieties.
It is worse since last summer after moving to a new town and getting a new job with an ex-army man as his superior. Sensation as if he cannot breath. Spasms in his esophagus and nauseous with it. Rotten smelling stools. (He also suffers chronically from worms.) Physically tense and nervous. Worse on the weekends and in company. Worse in buses and in cars. He feels he needs to be able to get away. He feels locked in, as if apart from others. Depersonalized. Stiff and panic. Clearcut fear of death.
The last year his back feels stiff as well, on the left of the vertebra next to his scapula. Main area T 5. Bruised and burning pain extending to his lungs. Pain < from cold and wet.

When he was nine years old he had been very ill with a high fever and delusions, especially in the evenings and nights before 24 hours. It started after holidays in the Alps. His sense of distances was gone and there were masses of people and flooding. He fell into other dimensions. Black holes. Waking with screaming. "I am dying, I am dying." His parents tried to comfort him, but he feared falling asleep again. Hospitalization for observation followed. Ever since then there have been fears and nightmares. For instance, about his mother who turned into a demon (she had premenstrual syndrome and could get aggressive now and again). The wind sucking him in, but also there were beautiful images sometimes, like an old oak tree on top of a hill.

At home he was often left to himself by his parents. In his early high school period he had panic attacks and often was hypochondrical. In his late puberty he had been a rebel, illegally occupying houses, demonstrating against nuclear warfare etc., but in fact he was not politically engaged. Never had been happy in cities, he prefers the quietness of the country. Depressions and suicidal thoughts, many images about suicide, and often lonely.
Six years ago a relationship broke off when he was educated in another country to become a carpenter. His friend was pregnant and felt forsaken by him. She blamed him a lot and for three years he was not allowed any contact with the newborn son. All the blaming had a repercussion on his self confidence, with powerless anger. He felt alone.

Sleep is well.
He likes exercise and mountaineering.
Psychically worse in winter.
Desires: bread, old cheese, tea, peppers, meat, eggs, dutch food, new herring.
Aversion: fats.
Hardly perspiring; not especially thirsty or thirsless.

In the past he had taken;
Nat-m.: depressions >
Ipec.: nausea >
Cina: worms >
Staph.: fears <
XXXX.: euphoric for some time.
Rhus-t.: back complaints >, fears <
All remedies were taken in the range 30 - 200; single doses.

I did not repertorize the case, because I had been thinking about XXXX among others, before he mentioned it. XXXX was Aconite, and I gave him a 10 M, single dose.

Follow up:
Second consultation after 4 weeks:
Fears gone; spasms much better, esophagus sensation much better. No oppressed breathing anymore. No doomed feeling about the future anymore. Rest and calm inside. Less tense, but there is still some burning pain near T 5. Stool improved, no worms anymore. More strength. Expresses anger more easily. Once he had fainted in the shop he works in. Some clairvoyant like dreams. In general much better.

He was very happy with my choice of Aconite, not only because it worked, but also because he had gotten a clairvoyant image last summer that he would encounter an important plant in the mountains where he was to spend his holidays. The first plant that drew his attention there was Aconite.

Eight months later:
He repeated Aconite 200 once by himself when he had an incomplete relapse and it worked some. On my suggestion he repeated the 10M, and it worked very well again. For extra information, he told me that he probably was an Aconite case from birth onwards, at birth he was almost strangled by his umbilicus.

The reason why I like to present this case is because of my impression apart from the complaints. In the consultations this man made a mild impression, even yielding, but only yielding up to a point. A bit Pulsatilla like, but with a little more ‘body’. He was very careful in his choice of words in order to make his feelings as clear to me as he could. His speech was even, a little slow and a bit round about. Certainly he was not rash or direct. He seemed an introvert who has chosen that he needs help, and opening up because of that. At the same time, I could sense he was alert to any subtle signs of rejection on my part. I needed to take a soft approach, to allow him to be as open as he could. Apart from his story, you could sense his vulnerability and sensitivity by just looking at him. Now and again he made big eyed glances at me, to assure himself I was still listening carefully.
This impression illustrates the ‘difficult concentration’, ‘timidity and bashfulness’ and possibly even ‘suspiciousness’ of Aconite, in a possible ‘constitutional case’ (whatever the ambiguity of the concept ‘constitutional’).

Case Two
Man, born 1963. First consultation 1994.
There is no ‘main complaint’ in this case. He comes to me to find out if homeopathy can offer something to improve his general condition.
I will give his story in the following order as he told it, which is a bit messy.

Since January 1993 he has been on Leponex (anti-psychotic) and he sleeps a lot on it. From 1990 to 1993 he has been on Imipramin (anti-depressive). The reason has been that he had ‘delusional ideas’. At the time it started he worked at the Justice Department, and he sensed that the police were watching him from the houses of his neighbours. He felt he was suspected to have stolen documents. The air-force was measuring his IQ. He had been studying economics, but dropped out. There was suspicion and a feeling of guilt, also about ‘some things’ in his youth. Since 1989 he has been in psychiatric care.

In general he feels worse in the evenings. He wakes up late and goes to bed late. Once he had the sensation that people were present in his sleeping-room. He bought arsenic against rats. He has difficulties concentrating and ‘thinking and acting seemed to diverge’. When he was about 20 years old he got the idea that something wasn’t right in his head and he had a lot of problems concerning high-school exams. Now there is structure in his life. He still has voices, thoughts in his head and uses lactulose to defecate once a day.
He likes Indian foods, spicy, sweets, chocolate, ice-cream and he is thirsty. He likes spring and autumn as well as forests and music. He never had an intimate relationship, he prefers to be free. He sleeps well, on his back. Dreams about being pursued. When he was 18 years old he dreamt about being asleep in a coffin. Two times he made suicide attempts (jumping in front of a train). Since the Leponex there is salivation during sleep. He bites his nails (always). As a kid he often was anxious about the idea that his parents would be dead one day. His father was a marine-officer. About 10 years ago he masturbated a lot. In his family, work has always been an important issue. He always has difficulty expressing anger and as a kid he feared robbers and the dark. He used to have examination fright and he often wonders if he does the right things. There is an empty feeling in his head.

As you see, the interview was quite messy and incomplete. I didn’t want to push him because he seemed to have a very fragile balance. He did his utmost to answer questions carefully. It seemed that guilt was a big issue.
After Kalium bromatum (30) he became less hurried and his ability to concentrate improved some. In general he felt warmer. He continued to have paranoid dreams and still heard some voices. He also tells about short manic episodes and when playing tennis he always wants to win. For many years he has diarrhea and he defecates about 6 - 8 times a day (contrary to what he mentioned in the first interview).
In a period of half a year he took Kalium bromatum again two times, and each time he reports feeling more rest inside. Once we tried Bromum without benefit. He felt locked in for a period after that.

Six years later in I see him again.
He tells me he has a tendency to postpone decisions and he often stays in bed till 11 o' clock.
Desires herring (2), salt and what is mentioned above.
Aversion to vinegar and fat.
After drinking beer he gets nightmares, for instance of being eaten by crocodiles and or lions.
In general he feels better among people. There are still voices in his head and paranoid ideas sometimes. Diarrhea is unchanged. Biting nails unchanged. Concentration difficult.
The diarrhea is worse in the morning, and he has to defecate immediately after rising. His stool often smell like rotten eggs.

Analysis:
This time I looked in the repertory at: 'rectum; diarrhea; morning; rising, after' and in the rubric just below it: ‘and moving about’. (In line with one of Hahnemann’s commands.) Natrium sulphuricum is in bold type in both rubrics. To me this was merely one foot to stand on. However, after I had looked at correspondences between common personality psychology and our materia medica (see Homeopathy in Reflexive Perspective), I had moved on to find clues. As to ‘paranoid’ I suspected on theoretical grounds that it would link mostly, but not exclusively, with the ‘possibly hostile’ (low scores on Big Five ‘Agreeableness’) columns and rows in the periodic table: columns 8 and 16 and row 6. Also possibly with the dependent and vulnerable columns and rows (high sores on BF Agreeableness): columns 2, 4 and 12 and row 2. Since the Sulphur part of Nat-s. is in column 16, I used that as a fuzzy confirmation. With Nat-s in mind, some other aspects of the case fit as well and so I gave him Natrium sulphuricum M, one dose.

Follow up:
Consultation 2 months later:
Diarrhea got worse at first, but stopped completely later on and he was very happy with that. His life got better organized and he had started a voluntary job. More important, no more nightmares. No more delusional and paranoid ideas.
After a slight recurrence of the diarrhea half a year later we repeated the Nat-s. He didn’t stop the Leponex on advice of his psychiatrist, but before it hadn’t been enough to stop the delusions.
Now, nearly a year later, he is still doing fine without paranoia and without nightmares.

The issue this case might raise is if psychic ‘end states’ can be inferred or induced from our known mental emotional remedy pictures.