It's a scary world out there: three cases of Arsenicum sulphuratum flavum

Case 1

PK is a 15 year old boy presenting with severe anxiety. He has been diagnosed with Aspergers syndrome and sensory integration dysfunction. There is a history of asthma and allergy to dairy and peanuts.

On first impression, he is an extremely engaging and likeable character. He is bristling with nervous energy; he fidgets in his seat, and his hands and legs are constantly moving, as though he is plugged into the mains. He has been this way for as long as his parents can remember. He has a long history of being disruptive and distracted in class. Anxiety is never far from the surface but is accentuated greatly when the exams come up: he dreads exams and his anxiety goes into overdrive at the thought of them. He talks in his sleep and tosses around, waking frequently during the night.

His paediatrician is keen to prescribe fluoxetine to help with his anxiety. For all his anxiety, however, there is a certain self-assuredness about him and he seems quite assertive. Socializing with his peers presents many challenges for him. He takes things very personally and can feel anger building up as a result. He then has to take himself away from the situation, as he can get quite aggressive. He is often intolerant with other children. At other times, he can be quite withdrawn.

His Aspergers syndrome makes him a slave to routines and he is very ritualistic. He likes to plan everything meticulously to feel that he is in control. If this is not possible, he can become extremely insecure and the aggression builds up. His parents provide the security for him and he worries about them going away. He listens to a lot of music in his spare time. He is very concerned about environmental issues and has a deep love of animals.

He has a great deal of sensory sensitivity, as is commonly seen with ASD: labels have to be removed from his clothes, his sense of smell and hearing are hyper-acute, and he gags on mushy food. When he is anxious, he becomes very loquacious and sweats profusely.   

Other symptoms: restless sleep, feet too hot in bed, heat and profuse perspiration at night.
Dairy <
Desires sugar which <

Analysis
The most limiting features in this case – anxiety, compulsive tendencies, insecurity, and restlessness – point to Arsenicum, more specifically, an Arsenicum of a non-chilly variety with a volatile temperament.

DD: Arsenicum iodum and Arsenicum sulphuricum flavum

His assertive and communicative nature pushed me more towards the sulphur aspect. He also has a tendency towards weight gain rather than the weight loss of the Iodines.

Vithoulkas says of Ars-s-f: “They become extremely touchy, are very sensitive towards criticism by others and are easily offended. They take everything too seriously, taking offence without cause and becoming quarrelsome, losing control and becoming furious.”

Prescription: Arsenicum sulphuricum flavum 12C, liquid plussed daily

Follow-up
Four weeks later: PK became much more relaxed and focused soon after the remedy. He is a lot happier in himself and feels more peaceful in situations that would normally make him extremely anxious. Perspiration is a bit less. However after a few weeks, he is feeling less relaxed and the agitation is creeping back in.

Prescription: Arsenicum sulphuricum flavum 18C

One week later (phone call): he became very agitated, hyper-active and argumentative shortly after the remedy; it has been difficult for the family.

Prescription : Arsenicum sulphuricum flavum 12C, single dose

Four weeks later: he improves instantly after a dose of 12C and continues to improve on two daily doses. Calmness is back, with fewer blowouts and agitation. He has seen his paediatrician, who is very surprised by the change in him and acknowledges the improvements from the remedy.

Six months later: he has been doing very well on 12C, but lately the original symptoms are beginning to creep back in.

Prescription: Arsenicum sulphuricum flavum Q1 every second day

Eighteen months later: he is back on track with Q1 and has improved further on Q2. After 18 months of homeopathic treatment, he is a happy guy who is realizing his potential, both academically and socially. He is no longer crippled by anxiety.

Case 2

KT is 9 years old. Her presenting symptom is recurrent tonsillitis with occasional bouts of strep throat. She also has high anxiety.

KT is slender and fair haired. She comes in with her Mum and barely looks at me; when she does look in my direction, she seems suspicious. She is very shy and apprehensive. I try to get a smile but she is having none of it. There is a real intensity about her. She is in between bouts of tonsillitis. She feels quite fragile and her vitality is low.

In the second half of the consultation, with just her mother present, I am able to get a good picture of her situation.

She has always been quite a tense wee thing and has always been very wary of men. She has high standards when it comes to schoolwork and can be a bit hard on herself. Her kindergarten teacher says that she is unusually empathic with other children when they are in distress. She is also very caring and loving with animals and has a bit of a menagerie at home. Reprimand affects her deeply. She is not keen on school and prefers to be at home.

I ask about the anxiety in more detail. There is always a low grade anxiety present throughout the day but it increases considerably in the evening and at night. She often senses eyes looking at her, and her biggest fear is that someone will break in to burgle the house. She feels generally unsafe but feels a little more secure in her bedroom doing something creative. She has been having many frightening dreams and her head gets hot at night. Music makes her feel better and she loves dancing.

Analysis

There are a lot of Carcinosin characteristics in this case but the predominant symptoms are her anxiety and the feeling that eyes are watching her, which is very specific. She needs a remedy which will address these aspects.

Rubrics

Delusion that she is being watched
Fear of robbers
Suspicious

DD : Ars, Bar-c, Calc, Hyos, Nat-m, Phos.

The closest remedy is Arsenicum. I decided on Arsenicum sulphuricum flavum, as I have seen this remedy work well for children with Carcinosin characteristics.

Prescription: Arsenicum sulphuricum flavum 12C, 1drop once daily plussed

Follow-up

Four weeks later: the fear of being unsafe is much better. She no longer worries about burglars or feels like she is being watched. Her energy and appetite have improved noticeably.

Prescription: Arsenicum sulphuricum flavum 12C, 1drop once daily plussed

Four weeks later: anxiety continues to be much less. No recurrence of tonsillitis or strep throat. She is showing more affection to the family.

Prescription: remedy as needed

Three months later: slight return of anxiety. No recurrence of tonsillitis and strep throat. Vitality is good.

Prescription: Arsenicum sulphuricum flavum 15C once daily

Five months later: doing really well. Very little anxiety and she is becoming more assertive, also smiling more.

Prescription: remedy only when needed

Case 3

KW is a six year old boy who has been referred by his general practitioner. He has issues with oppositional behaviour and his constant meltdowns have been a real challenge for his family.

At our first meeting, K is quite shy and nervous. He is of slight build and looks very serious.

He has always been a sensitive soul and this could have been compounded by the death of his childminder when he was three.

His mother says that when he is feeling good, he is very loving, affectionate, and happy but his anger outbursts are becoming much more frequent lately. He can be very abusive and insulting. He has a high degree of sensory sensitivity to noise and touch, especially his head; he hates having his hair cut or washed. He likes routine and has to plan everything in advance.

It is like walking on eggshells around him; you never know when he will fly off the handle. He hates change and has to know what is happening well in advance. When he is reprimanded, it goes very deep and he takes a long time to get over it.

He is very careful with his work. He loves building things and makes things precisely to his plans. His Mum says he is a perfectionist like his Dad.

With his outbursts, it is like the whole world comes crashing down. It takes a while to calm down but when he does so, he is quite remorseful. He has a group of friends that he is close to and socializes well with them. He is very fond of animals and loves spending time with them.

He has a fear of robbers breaking into the house and of being alone in the house; he always wants to have someone around. He has frequent nightmares. He loves to collect bric-a-brac.

Other symptoms: bruxism at night, thirst at night, offensive odour from feet Desire: white chocolate

Analysis
He is an anxious child with a fear of invasion. His attempts to stay in control are shown in his perfectionism and also in his outbursts when things are not going his way.

Rubrics
Fear alone
Fear of robbers
Conscientious
Teeth grinding sleep

DD: Ars, Bell, Lyc, Phos, Stram, Verat

His fear of invasion / robbers and his perfectionism indicated Arsenicum. The Sulphur aspect was also present in his opposition, hoarding and foot odour.

Prescription: Arsenicum sulphuricum flavum 12C, 1drop once daily plussed

Follow-up

Four weeks later: his mother says that there been a dramatic change for the better. There have been hardly any meltdowns and he has been much more even-tempered. His anxiety has improved noticeably. Bruxism is less.

Prescription: Arsenicum sulphuricum flavum 12C, 1drop once daily plussed

Four weeks later: still holding the improvement. He is more easy-going with change and his sensory sensitivity is less. He is empathizing more and hates to see anyone suffering.

Prescription: Arsenicum sulphuricum flavum 15C, 1drop once daily plussed

Four weeks later: anxiety, sensory sensitivity and bruxism returning.

Plan: wait

No change after waiting.

Prescription: Arsenicum sulphuricum flavum 18C, 1drop once daily plussed

Three weeks later: symptoms have improved again and he is doing well.

Comments
The children I have seen, who have responded well to this remedy, have been emotionally and physically over-sensitive. They have lacked the normal boundaries that protect them from outside influences (DD: Phos) and some can react angrily when their security is threatened. I have seen it work well for children who exhibit many Carcinosin traits, such as being sensitive to criticism and sympathetic, as well as a love for animals, but they also exhibit Arsenicum level anxiety and compulsiveness as the deepest symptoms. When repertorising these cases, one will usually arrive at Arsenicum album but this remedy may not cover the case adequately.

The combination of sensitivity, compulsive issues, and anxiety make Arsenicum sulphuricum flavum a useful remedy for children on the autistic spectrum.

Photos:
Wikimedia Commons: girl suffering from anxiety; Bablekan
Flickr: holding my breath until I turn invisible; qwrrty
Flickr: Asperger; Irina Slutsky