Illegitimacy and survival: a case of Leprominium

Kate, a woman in her mid 50’s presented in January 2011 with an ongoing skin condition. She has had dermatitis on her right calf for the last 10 years but recently, things have deteriorated. She has had a series of both streptococcus and staphylococcus infections: initially on her foot, more recently in her armpits, and at the time of initial consultation, eruptions at the back of the neck. She has been taking an assortment of antibiotic and steroid treatments to no avail.

She describes the neck, armpit and foot eruptions as hot, tight and itchy, sensitive to wind, touch, and water. The eruptions are red, inflamed, pimply, and full of pus. They feel “on fire” and she describes “a terrible clawing feeling, a desire to rip it off.” She has recently been very angry because of difficulties in a close friendship, and she connects this anger with the inflamed condition of her skin. She fears the eruptions will spread and take her over. The chronic condition in her calf is dry and itchy, and has for the first time spread to the left calf as well. She feels vulnerable, fragile, and self-obsessed. When asked what the disease means to her she replies: “It’s ugly, an invitation, too big a challenge, a weight inside me, something I’m hiding or pretending about.”

Aetiology

The first staphylococcus outbreak, 9 months previously, happened whilst she was on holiday with her partner, who mostly still lives with her husband and children for the sake of family practicalities. During the camping holiday, her partner had to unexpectedly leave on a work matter. Kate’s foot erupted in such an alarming manner that she went to the emergency department of the local hospital. Being both far from home and without her partner sparked feelings of helplessness and difficulty. On reflection, during the consultation, she realised that the whole event had triggered deep childhood patterns.

She tells: “My core issue is illegitimacy; I feel different and separate from my family (of origin) and feel I can’t have what I want, the love that I want. I didn’t understand the family dynamics, I just didn’t feel the same as them, unequal. I was the result of an affair. They put my mother’s husbands’ name on the birth certificate and said nothing more about it. I didn’t know about this until I was 24. I’ve felt very angry about this; it was my right to know. The whole family continues not to acknowledge that I’m different. It was all kept so secret, but I was treated differently: the promises were never fulfilled, my siblings got things I never got, I didn’t have the same rights. I’ve worked on it a lot and have resolved it hugely. I get triggered, if I can’t resolve something in a relationship, if I can’t understand someone’s response or behaviour, or if my life’s not working well. When that happens it’s terrifying: I want to try to control the other person, force them to talk or listen. Everything gets shaky and there is no solid ground. As a child, it was the same: everything was intensely confusing, traumatising, and tight. I was a most difficult child; rebellious, rude, uncooperative, and bad. People now find me abrupt and rude. When I’m like that, I now know it’s from a need to defend myself in the world; pushing people away and protecting myself from the risk of being let down.

“My father went to Canada, it’s a disaster! He is in a dysfunctional family. I went to visit him and we had a natural affinity, but his wife felt threatened and made him choose - I got rejected. It was good to see where I come from: he understood parts of me that my family didn’t, but then he reinforced the old story. I don’t even know if he’s still alive.

“It all has to do with approval and legitimacy. I realise that ultimately it has to come from inside. Socially, I struggle to feel like a legitimate member of society. I admire people who move themselves forward socially. I take it personally if my social life isn’t going well, it can paralyse me; I isolate myself and feel unloved, unrecognized, and inadequate. Over the last few years, I’ve been learning about love, learning how to be unconditional with love and learning what can come out of that - I’m placing value on that. I’m learning that love has to be internal, that it starts with me.”

Also of note in the case are early greying of the hair (from age 19), menopausal hot flushes, a strong desire for sweets, and a road traffic accident which she describes as “the biggest marker in my life; it caused me to be truly vulnerable and to receive a lot of love and care.”

 Prescriptions

Several well-indicated remedies failed to act. Over the course of two months, however, her state improved somewhat with the help of Staphylococcus 200C. The eruptions of the neck healed and the chronic eruptions on the calf improved but remained ‘brewing’ beneath the surface. Her armpits healed initially but later returned with a vengeance. She described an itching that “feels like it will never stop, an urgency to make it stop, a fear it will devour me, like something that is alien and other.” She feels in limbo with her relationship and is desperate to see it validated, made legitimate.

She tells a little more about her mothers’ story: “She was terrified; she left her husband to live with the man she’d been having an affair with. When she discovered she was pregnant, his passion faded quickly and the relationship ended. She tried unsuccessfully to abort. In desperation, she contacted her ex-husband, whom she discovered was about to leave England for New Zealand to start a new life. With few options available, she stayed with her parents until she could get a boat to NZ. She had thought to adopt me out if I was a boy, in case I was too much of a reminder. My presence was difficult for her. Being legitimate is about survival; you get claimed, taken care of in the world.”

At this point, two months into treatment, I prescribed Sulphur Q3, which matched several generals in the case and also the relationship issues, albeit in a somewhat simplistic way. The response was positive. The hot flushes calmed, the eruptions on the neck, armpits and feet healed, and the intensity of feelings in the relationship also improved. She felt less driven and less defined by her emotions. Legitimacy became a less dominant issue. She talked of an emerging inner voice, the voice of a friend.

Six months later, Sulphur ceased to act and she returned to the clinic. The calf (the original site of chronic dermatitis) was inflamed, itching, and weeping; she described it as “small but vicious”, and could not stop scratching it.

During the consultation, we both expressed our frustration at the incompleteness of the healing process. I implored her to tell me what I don’t yet know. She shared the following:  “A fear remains: I want soft smooth skin but my deep fear is that I will always have yucky skin and I don’t like myself like that. It’s  as though there are two separate me’s: me looking at the me I don’t want to become, like I can split something off. It doesn’t feel good.” I asked her what the problem with yucky skin really is. She replied, “A person with yucky skin is unappealing, people won’t want to touch her, she would be yuck, she’d be very isolated, there would be a complete barrier between her and the world.”

What followed was a unique experience in the clinic for me, perhaps as a result of a strong empathetic feeling with the patient. As she was speaking, a strange and dreadful sensation came over me; I felt like I was about to vomit, as if something truly revolting was inside me. Fortunately, I did not vomit, instead I found myself compelled to ask: “Do you mean like a leper?” 

She turned quite pale and replied “Yes, how did you know? I wanted to say the word but couldn’t bear to. I have always been interested in lepers; morbidly fascinated.”

We sat for a few moments, taken aback at this truth that had arrived, a likely simillimum in the form of Leprominium. To ground the prescription, we can readily see the strong similarities with many of the Leprosy miasm keywords, as derived by Rajan Sankaran: disgust, isolation, tears himself, repulsion, secluded, castaway. Materia Medica and a few reported cases in Links report a strong affinity with skin conditions and premature greying.

She responded beautifully to the Leprominium, taken initially as 30C and later as 10M, of which she has taken two doses to date over the last six months. The skin eruptions on the calf have receded to barely a trace for the first time in 10 years. She reports feeling increased well-being and a sense of spaciousness in her emotional self. She describes it as having an “open window within” that she can choose at anytime instead of a negative emotional response or thought. Her sense of self, her presence and belonging in the world has changed. She no longer isolates herself, there is no need to externally legitimise herself or her relationship, in which she feels content. In short, she has claimed herself.

References
Sankaran R., Sankaran’s Schema 2007 Edition
Konig P.,Homoeopathic Links; Winter 1996 Two Small Remedies
Vermeulen F., Synoptic Materia Medica 2

Photos: Wikimedia Commons
Hhydroa-vacciniforme girl; dr Utsavsharma
Leprosy bell; Cnyborg