Poisoned by leeches: a case of Hirudo medicinalis

Female, 18 years old; chief complaints: metrorrhagia (since onset of menses), anorexia, suicidal depression; family history of suicide, cancer, and depression

Observation: Height 5’5”, weight 90 lbs., raven-black hair wrapped in a tower upon her head.

Initial consultation, April 2011

Patient (P): “I am extremely anxious and feeling suicidal. I won’t sleep unless I am completely exhausted or I am taking drugs (I have tried everything). I am exhausted at bedtime, then I suddenly feel exhilarated, alive, in some half-dead, way. Exhilaration and anxiety are hard to differentiate. I have always been an anxious person. Sometimes, I feel scared to death to fall asleep. It’s so hard to sleep.”

MIND - ANXIETY - suicidal disposition, with

MIND - EXHILARATION - night

MIND - FEAR - sleep - before

SLEEP - FALLING ASLEEP - difficult

SLEEP - SLEEPLESSNESS - exhaustion

“I also have excessive bleeding with my menses. This has been since I started menstruating when I was nine. I have terrible nightmares before my menses. I get sharp stabbing pains in my ovaries. My menses are rust-brown colored. I have been diagnosed with pernicious anemia.”

FEMALE GENITALIA/SEX - MENSES - brown

FEMALE GENITALIA/SEX - METRORRHAGIA

FEMALE GENITALIA/SEX - PAIN - Ovaries - sharp

DREAMS - NIGHTMARES - menses - before

GENERALS - ANEMIA - menses - after - agg.

“My dad told me that I was fat and ugly as a child. I only eat one meal a day. I prefer to drink my meals (like smoothies). I will sometimes wake to vomit early in the morning between 3 and 4 am. I have anorexia.”

MIND - ANOREXIA NERVOSA

GENERALS - FOOD and DRINKS - liquid food - desire

Homeopath (H): Can you say more about half-dead and scared to death?

P: “Half-dead, means like the vampire who sucks your blood until you barely have an ounce of blood left in you… Once when I was about four years old, we went swimming in this lake, my brothers and me, and we were covered in leeches; I was terrified. I passed out. I remember everything going white, and then hitting my head on the ground. My Nana helped us. She was the only good thing in my life and she died in her sleep when we were staying with her a few years later…

“My entire childhood was traumatic; my parents were fighting constantly, that scared me to death. I was so anxious. I had the constant feeling of being watched and that someone was going to come after me if I wasn’t good. I was always afraid that if I fell asleep I would die before waking, like that children’s prayer, ‘If I should die before I wake…’ ”

MIND - DELUSIONS - pursued; he was

MIND - DELUSIONS - watched, she is being

MIND - FEAR - death, of - sleep - falling asleep - after

“I am really afraid of dying, yet I am afraid to live. My Nana represented life to me… It’s funny that the most frightening experience of my life, that day of swimming, was also one of the best days of my life. It’s almost like those leeches poisoned me and made me half-dead.”

H: Can you tell me anything more about that day at the lake?

P: “Sometimes, when I am so exhausted and I can finally sleep, I have these horrible dreams: I see myself covered with those leeches and then I pass out. When I fall, my head and body merge with the ground that I fall into, I merge with the earth, the mud, and my Nana comes and plants a garden in my body. It is a very bizarre dream.

“Since Nana died, I don’t believe that people are there for me, I feel that she was the only one to pick me up and dust me off; everyone else just leeches off of me.”

Repertorization using Synthesis 2009V

MIND - ANXIETY - suicidal disposition, with

MIND - ANOREXIA NERVOSA

MIND - DELUSIONS - pursued; he was

MIND - DELUSIONS - watched, she is being

MIND - EXHILARATION - night

MIND - FEAR - death, of - sleep - falling asleep - after

MIND - FEAR - sleep - before

FEMALE GENITALIA/SEX - MENSES - brown

FEMALE GENITALIA/SEX - METRORRHAGIA

FEMALE GENITALIA/SEX - PAIN - Ovaries - sharp

SLEEP - FALLING ASLEEP - difficult

SLEEP - SLEEPLESSNESS - exhaustion

DREAMS - NIGHTMARES - menses - before

GENERALS - ANEMIA - menses - after - agg.

GENERALS - FOOD and DRINKS - liquid food - desire

Key points to consider:

Anemia

Anxiety

Anorexia

Menstrual problems

Paranoia

Sleeplessness

Analysis

Repertorization indicated remedies such as Carcinosin, Medorrhinum, Ferrum metallicum, and Lachesis mutans. When repertorizing such an unusual case leads to such common polychrests, we need to consider a different approach. The recurring theme of leeches led me to explore the obvious (something I was cautioned against in homeopathy school). I found the proving of Hirudo medicinalis, the medicinal leech, published in Dr. Pichiah Sankaran’s The Elements of Homeopathy, and more on the remedy in Clarke’s Dictionary of Practical Materia Medica and Vermeulen’s Synoptic Materia Medica II.

Hirudo medicinalis covers dangerous hemorrhages, anxiety, disinterest in food and eating, female menstrual problems, sharp pains in the ovaries, and left sided complaints. I chose Hirudo not because leeches were a central image for the client, but because on reading the limited materia medica references, it fit her case so well.

Prescription: Hirudo medicinalis 200C, one dose

Telephone acute consultation two months later, June 2011

P: “My period started two weeks early and I am really, really bleeding, a weird mixture of rust-brown color, dark red, sometimes almost black. It’s terrible. I have also been experiencing dizziness and sadly an insatiable appetite. It’s like you turned on my appetite with that remedy.”

Prescription: reduce aggravation with Hirudo medicinalis 200C plussed in 2 oz. of water, stirring for two minutes, one dose = one teaspoon every 12 hours for three doses.

Follow ups

October 2011: “I am much more stable, a lot less anxious. After taking the remedy in water, my flow slowed and then stopped within three days. My ravenous appetite has also decreased. Unfortunately, I have gained about 8 lbs. I am feeling a lot of grief and depression, but I am not feeling suicidal like I used to. I am feeling more alive than half-dead.

“I am still having trouble falling asleep. My dreams have been very vivid. In one dream, I pop a pimple and out comes this white worm-like thing, it’s a leech; it was so incredibly gross. The worst thing is that when I woke up I had an enormous pimple in that spot under my left breast.

“I had horrible sharp pains in my stomach, usually I have sharp pains in my ovaries, but that hasn’t happened.”

Prescription: Hirudo medicinalis 200C, one dose

February 2012:  “That underlying sense of depression is lessening, and my grief feels like its stronger. I found a picture of my Nana. I feel like someone really did love me as a child (even if it was only for a short time). I guess you could say that the remedy has helped me to detach from the negative voices of my dad inside my head.

“I am sad to report that I now weigh 110 lbs. I am eating several small meals a day. I am trying to be more conscious about eating, but my appetite is here to stay. Overall, I am much less anxious, less troubled overall. Disappointed about my weight, but honestly, I hate to say this out loud, I feel accepting of my body for the first time in my life.

“I now fall asleep easily. I am really feeling alive. I also feel Nana’s presence in my life and in my choices around going to college. I feel her love and support.”

Prescription: wait

Final analysis

This patient did remarkably well on Hirudo medicinalis. She has occasionally received single doses of Hirudo medicinalis 200C or 1M, or plussed doses, with an occasional acute remedy given as needed. Her life long anxiety and suicidal depression completely resolved, her menstrual difficulties and pernicious anemia also resolved. She is currently maintaining a weight of 119 lbs. Happily, her nightmares have also dissipated and she sleeps soundly for the first time in her life. She continues to dream of her Nana, as a force of goodness and love in her dream life. She is finishing college in Food Science & Nutrition some four years later.

History of Leeching

Hirudo medicinalis, as its name implies, was used in medicine as early as 600 BCE in Ayurveda and in the second century CE by the great Roman physician Galen. The use of leeches for bloodletting, widespread throughout Europe and America in the early 19th century, was denounced as barbaric by Hahnemann in the Organon. Compton-Burnett championed the use of potentized tincture of leech (then known as Sanguisuga) as a remedy for hemorrhages.

Leeches - aquatic segmented worms - are powerful bloodsuckers because of their hundred-odd teeth plus substances in their saliva that anesthetize the wound (so that the victim is unaware of the bite), dilate blood vessels to increase blood flow to the site, and prevent blood clotting. It is truly amazing that this substance used as a homeopathic remedy may be used to heal rather than harm.

Photos: Shutterstock
Woman with stress; aastock
Leech; sydeen