CASES

CASE1

Arsenicum album

 Case

 Girl, 10 years old

 May 25, 1988

 Lately there have been many discussions about repeating the remedy. In the Center we just try to cure our patients, and if you do that you get other ideas about when to repeat the remedy and when to wait, other than what you read in the books.

 Surely there are cases in which you have to wait as long as it is written, but often we are confronted with situations in which we just can't tell the patients, "You have just received your remedy, therefore we have to wait, and you have to suffer." In these kinds of situations we have to give the right remedy. That's flexibility. The patients don't behave according to our rules, we have to follow the patients.

 Everything I show you here is daily practice, and each one of us will be in the same situation one day. Again and again, we do not recognize the remedy, because we don't know our materia medica profoundly enough. I don't know it well enough either, but what I know, I tell you.

 How often somebody says, "I gave the patient the right remedy", and when he comes back with appendicitis, pneumonia or something like that, it means, "It can't be true, I have just given him the right remedy. I must wait." Yes, it was the right remedy, but now he needs another one. Often we stick to the constitutional remedy and we don't dare to give another remedy. The patients start coughing, get pneumonia and things like that, go to the hospital and there they get antibiotics. We know that antibiotics work suppressively in these cases and you have to start all over again in these patients. Every one of us who works consistently knows these things. If you have a chronic patient who you have to send to the hospital you cannot make theoretical conclusions in that case. You can only make conclusions from practice. If you start treating a patient, give him the remedy, after two years he comes back with an acute disease, you can solve this problem, for example, by repeating his constitutional remedy. After a few years you can say how he developed. That's homeopathy. According to what we see in practice we can make our theories. Homeopathy is not prescribing one remedy, waiting to see whether he is doing better and then sending him to a psychiatrist when he has psychological problems or prescribing tea when he has inflammation of the bladder. We have to face the problems and we have to give a remedy at the right moment.

 And be honest! Exactly speaking, we do not understand the human being in his essence, we can only try to give the indicated remedy at the right moment. That's what Hahnemann said, similia similibus, but he didn't say that it should be only one remedy for the rest of his life. We have to see everything in time, for a certain moment of life. Somebody needs Causticum today and one year later he might need Tuberculinum.

 We don't know the development and the background precisely, we can only try to recognize the remedy and to give it at the right moment.

 The same goes for potencies. Some of you have experience with LM potencies, others have experience with high C potencies. Both work. But how often do we have to repeat?

 Nobody knows exactly. In one patient you can wait for one year, in another patient you have to repeat after four, five weeks. Also on this point we have to be flexible.

 The next patient is a girl, born in 1978, who has been in the Center many times. Before I saw her the first time she had already received two remedies. I know her mother, a wonderful Calcarea woman, her father needed another remedy. Because I knew both of them it was rather easy for me to find the remedy for this girl.

 A : You have been seen here before by a colleague and I also examined the case once. Up to now there hasn't been a clear amelioration. Your problem is anxiety. Tell me when it first appeared.

 MP : When she was about 5 years old.

 A : Now she is 10 years old.

 MP : Yes. At that time she had anxiety for the first time.

 A : Anxiety together with vomiting. When did it appear the first time?

 MP : When she was forced by the teacher to eat her food at school.

 This is one of the possible causations for anorexia nervosa. She is afraid to eat something because she will vomit it. Who knows the rubric for anorexia nervosa? One possible rubric?

 Audience: On page 39: Mind, Eat, refuses to.

MIND,EAT, refuses to : Ars., bell., caust., cocc., croc., grat., Hyos., ign., Kali-chl., kali-p., op., Ph-ac., phyt., plat., puls., sep., Tarent., Verat., Viol-o.

 A : Right. The remedies in this rubric come into play when you have to treat someone with anorexia nervosa.

 MP : The teacher forced her to eat slices of bread. But she has always been an anxious child. For example, in the past she slept with us for half a year after she had febrile convulsions. She was very anxious, even at that time, but actually everything started after the convulsions she had during fever.

 A : How old was she then?

 MP : She was already walking, and she was 1 1/2 years old when she started walking. 

 A : What disease did she have at that time?

 MP : An inflammation of the throat. I know exactly. She was examined from head to toe and then they diagnosed an inflammation of the throat.

 A : Since then she hasn't had any cramps?

 MP : No.

 If you have something like that in the history of a patient you must try to understand why she had the convulsions during fever. It is important to ask what happened at that time. For example, was she teething?

 For example, we had a patient with convulsions during dentition who needed Artemisia vulgaris. Artemisia vulgaris is one of the most important remedies in puberty, for girls in puberty who get painful convulsions during their menses, and who as a child had convulsions during dentition.

 What remedy did this patient need at that time? Is it the same one she needs now? Maybe yes, maybe not.

 Or do these two remedies follow each other well? You will find the relationship of the remedies in the book "Arzneimittelbeziehungen", one of the most important books for advanced homeopaths.

 I know what remedy she needs now, and Belladonna is a convulsive remedy which is related to the remedy she needs now. Probably she needed Belladonna at that time also. 

 The second point I want to draw your attention to is that in the first anamnesis you should not forget to ask about all the former diseases and diseases of the family and to write them down. Tuberculosis and cancer are very important. One day there will be a state for which you have to give Tuberculinum or Carcinosinum. Because we know the history of the family we know that there is a weakness in the family. This is the so-called miasm, which normally appears after the constitutional remedy.

 A : At that time she was very hot.

 MP : Yes, or weren't you? Say it, Tine.

 A : Actually you should know.

 MP : Yes, yes. She had about 40° C fever.

 A : The convulsions during fever didn't come back, and then the anxiety started. Which were the strongest anxieties?

 MP : There were not so many. She didn't want to sleep alone and had fear of the dark.

 A : This was after the febrile convulsions?

 MP : Yes, this was clearly afterwards. In general she didn't want to be alone.

 A : So fear of being alone.

 MP : Yes.

 A : Was it when she was alone at night in the dark?

 MP : Yes.

 A : Somebody had to be with her.

 MP : Yes.

 Anxiety when alone. If you have such a symptom look for the rubric in the Repertory and have a look at the remedies.

 In this rubric there is one addition: Gallicum acidum.

 MP : She was really in a panic. When she had to go upstairs alone she didn't dare. We were surprised that she was so afraid.

 A : We can say that she is not afraid in the dark when she is not alone.

 MP : Yes. She is only afraid in the dark when she is alone. Now also.

 A : How is it when you are with her?

 MP : Actually it is only when she is alone.

 (to her daughter) Are you afraid when papa and mama are away in the evening?

 P : (doesn't answer)

 A : That's an anxiety which she surely has. Does she have other anxieties?

 MP : I don't know. Yes, fear of failure; that's the main anxiety.

 FP : When we do something out of the ordinary or when something is expected of her.

 A : And when she has to go to school in the morning?

 FP : Then she starts vomiting.

 MP : She doesn't want to eat anything at all, and she is afraid she will vomit.

 What kind of anxiety is this?

 She has to go to school and then, before -

 Audience: ... (not understandable)

 A : Yes, this is a fear from anticipation. There are a few rubrics for this kind of anxiety, for example:

 MIND, Anxiety, expected of him, when anything is

MIND,ANXIETY,expected of him, when anything is : Ars.

 MP : She is also afraid of other people. When they say something about her; she can't tolerate when they make remarks about her.

 FP : When the teacher makes a remark, for example, that she couldn't go swimming for a few weeks, she can't tolerate it, she becomes angry.

 MP : No, she cannot tolerate that.

 A : Does she weep then?

 MP : (to her daughter) Tell him the truth, dear.

 Another expression for this anxiety you find on page 7:

 MIND, Anxiety, railroad, when about to journey by, amel, while in train

 This is the same kind of anticipation anxiety, a real deep anxiety, not only a superficial fright.

 A : Does she also weep then?

 MP : Yes.

 A : I mean because of the remarks.

 MP : Actually this has become a little bit better, but she still weeps. She wants to be the boss a little bit.

 A : In what sense is she dominating?

 FP : She dominates all her girlfriends.

 A : So she dominates all the others.

 MP : Yes, if somebody else is the boss she doesn't go along with her.

 A : Does she tolerate contradiction?

 MP : No, no, she doesn't.

 Doesn't tolerate contradiction.

 A : That's strange. She is anxious and yet she wants to be the boss. Does she have other remarkable characteristics?

 MP : Tine, do you know of some?

 FP : In the morning she goes to school with anxiety. She is anxious about certain tasks, and thinks she can't do them.

 MP : She doubts herself.

 FP : She doubts everything she has to do. "Will what I do be good ?" and so on.

 A : Give me an example.

 FP : She had to perform a poem at school and weeks before she was very excited. She was unbearable. She thought about it constantly how she would perform it in the best way, and on that particular morning she was terribly anxious.

 MP :  And then she was the best.

 FP : The result was very good.

 MP : Yes. Actually she was the best and she thought she couldn't learn anything.

 A : Is she very tidy?

 MP : She is rather untidy.

 A : What do you mean?

 MP : Concerning her things for school she is not untidy, because she thinks the teacher might make remarks.

 A : At school she is very tidy?

 MP : She is very careful and is very clean concerning things for school.

 FP : But at home she throws everything in a corner.

 MP : And she cries a lot. She is always very sad, because of the anxiety.

 A : Do you have to be with her?

 MP : Yes, she clings to me all day.

 A : Is she sensitive to coldness?

 MP : No, actually not.

 She has anxiety and she is first in her class. Anxiety when somebody is last in the class is which remedy?

 Baryta carbonica.

 Remark: ...

 A : Yes, you find this rubric on page 91:

 MIND, Undertakes, nothing, lest he fail: Arg-n, sil

 But with her the anxiety goes along with very high intelligence and fastidiousness. Her schoolbooks have to be in tip top order.

 Here you could also think of Argentum nitricum, but the anxiety from being alone doesn't fit the picture of Argentum nitricum.

 A : Is she economical?

 FP : She is not interested, she doesn't save for sweets.

 MP : She likes to eat, also sweets. She is also very honest. When she has done something she says so, but she doesn't make up things. She is a very nice girl.

 A : Does she dare to do anything?

 MP : No, no, not like the other children. Actually she doesn't dare anything.

 The main idea of this remedy is insecurity. Anything which is insecure gives anxiety.

 Normally this remedy is also stingy. They want to have everything. You can find this in the rubric on page 35:

  MIND, Desires more than she needs

 You find this also in the rubric on page 9:

  MIND, Avarice

 Her parents have enough money, she gets what she wants. Maybe therefore she is not so stingy, therefore there is no insecurity on this level. There is insecurity at school because she has to show, to prove her knowledge.

 Often these people talk behind the back of someone else. You know this rubric?

 Look in the Repertory on page 81:

  MIND, Slander, disposition to

 And do you know which remedy doesn't tolerate this at all? Who becomes irritated when he hears someone talk behind the back of somebody else?

 Causticum.

 In the rubric "disposition to slander" the remedy for this girl is there. The joy at the misfortune of others is an expression of their stinginess. They begrudge others and are happy about their misfortunes. You find the corresponding rubric on page 60:

  MIND, Joy, at the misfortune of others

 Remark: ... (not understandable) ... malicious joy.

 A : Yes, on page 60, "Mind, Jesting, malicious", this describes the same feeling.

 MP : Sometimes she can also be very spontaneous, for example, towards her teacher: she thinks about something and she says it right away. She dares to do that.

 FP : She thinks about something and she says it immediately. Afterwards she thinks, "Oh dear, what did I say! I wish I hadn't!"

 A : She is very spontaneous.

 MP : Yes, in certain things.

 FP : Actually this is not so clear with her.

 MP : No, not a spontaneous child. Tine, think about it yourself.

 FP : She is worried about everybody.

 A : She is overconcerned.

 MP : The mother of a girlfriend of her class died and she talked again and again about this. She said, "Mama, you won't die" and she was very much occupied by this. When there is something wrong with me immediately she is worried.

 So this is one possible causation. When the constitutional susceptibility is undermined symptoms appear. If someone in the family, an acquaintance or a friend dies this is the onset of the symptomatology. This is the cause in about 80% of the cases. If you have such a patient who is suffering from anxiety which began after the death of his grandfather, his grandmother, a friend, in 80% of the cases it is this remedy.

 In Belgium it is a custom to pay your last respects to the dead person in an open coffin. These people are not able to face the pale dead person, to look death in the eye. This is very typical for this remedy. It has a lot to do with death.

 MP : With the slightest injury she fears the worst right away, with the slightest loss of blood.

 A : Does she bruise easily?

 MP : Yes, yes, she constantly has blue spots.

 Now you see why this remedy has anxiety about others. It is because of their insecurity. "If something happens to someone else, what will happen to me?"

 The anxiety about others is very strong in this remedy, but not out of sympathy like in Phosphorus, but because of their own insecurity, for purely egotistical reasons.

 FP : If she has an injury it has to be taken care of immediately.

 A : If something happens to somebody else is she also anxious? Is she afraid something might happen to her?

 MP : No, she is worried, she is concerned about the other.

 A : Actually, sympathetic.

 FP : When there is something wrong with the cat, or another animal...

 MP : She always looks at me and asks, "Mama, are you sad?" Actually she sees everything.

 A : And on television? Is she also sympathetic?

 MP : Yes.

 In taking a case it is good to start from a rubric for which you have a real sure symptom. You write down, anxiety alone, and that's all. Assuming that this rubric is complete, you can start by eliminating one remedy after the other. But never forget the rubric from which you started and look which remedy comes through.

 In this way you can also find Drosera in skin diseases. Drosera has skin symptoms and nobody knows it.

 The anxiety from being alone in Drosera appears in which situation?

 Audience: In cough.

 A : Yes, in cough, in barking cough, bass voice, laryngitis, then they need somebody nearby, but also in other situations, in skin diseases.

 You also see Mezereum in "fear alone". At the Small Remedies Seminar I showed a Mezereum case and there you could see that Mezereum can be completely crazy with skin symptoms.

 Cocculus is also in the rubric and some other remedies.

 Remark: ... (not understandable)

 A : Oh, I apologize, Cocculus is in the rubric "anxiety about others", I mixed up both rubrics. We will come back to this remedy in anorexia nervosa, "refuses to eat".

 A : Does she drink a lot?

 MP : Yes, she drinks a lot of water.

 A : All at once or in small sips?

 MP : A lot.

 A : Large draughts?

 MP : Yes.

 A : Cold?

 MP : Yes, cold.

 The general symptoms are clear and are sufficient to prescribe a remedy on. She has a big thirst for large quantities, for cold, or she drinks very often with small draughts. Hyoscyamus is also in the rubric "thirst for small quantities", and usually they like warm drinks.

 Further she is very chilly, very restless, exhausted, has a big thirst for cold drinks, burning heat, ameliorated by warmth, this clearly indicates one remedy.

 MP : She doesn't like it warm, or does she?

 FP : Yes, in winter she drinks tea.

 MP : It's difficult, I don't know exactly.

 For the rubric "thirst for large quantities" I give you two additions from my own experience: Podophyllum and Tuberculinum.

 A : For example, did she drink anything warm yesterday or the day before yesterday ?

 MP : A little bit of coffee.

 A : Does she drink the warm drinks also at once?

 P : When I like it I do, but usually not, actually I drink with small sips.

 A : Is she open by character?

 FP : No.

 MP : No.

 If she would be spontaneous of which remedy would you think?

 Audience: Of Phosphorus.

 A : Yes, of Phosphorus. But this remedy is not spontaneous. This is an important differential diagnostic point. Indeed, Phosphorus can come into an indifferent state, indifferent to others, but in general, they are spontaneous.

 MP : Actually she doesn't say anything easily by herself. She just sits there and if we don't ask what's wrong with her she won't say anything.

 A : Actually what's behind her anxiety?

 FP : I think she is anxious that she won't do things well enough.

 A : What does she feel then?

 FP : Her character is behind all this, I'm sure.

 This kind of fear that she won't do something well enough is another idea. They have the desire to enjoy people. This is also the main idea in Carcinosinum, but you know that Carcinosinum doesn't talk behind people's backs. They do not fight, but Carcinosinum lets himself be suppressed. They are sensitive to contradiction, but they won't fight. When they get admonished they start crying and go away. They won't do anything against it, they let themselves be suppressed instead, and at the same time they do everything to please their parents.

 This patient does the same, but for another reason, out of insecurity.

 A : When she was 5 years old did someone in the neighborhood die?

 MP : I don't know, but of course I don't know what her teacher did at that time. The teacher was dismissed. What she did to these small children I don't know. I heard many complaints from other mothers. Whether she put them under pressure or whether she threatened them, I don't know.  Actually, we don't scare our children, we have never threatened them. We don't do anything like that.

 A : Do you know whether she often talks about death? Whether this is a problem for her?

 FP : Maybe she thinks about it.

 MP : (to her daughter) What about dying, death? Did you think about the mother of that child at that time?

 P : Yes.

 MP : If she is so concerned about this I always tell her that she has to study, that she doesn't have to take it to heart. When I tell her it helps. She still has to learn. (to her daughter) I always tell you, don't I?

P : Yes.

 MP : But whenever she thinks about it she becomes very anxious.

 A : If she sees something on television which has to do with death how does she react?

 MP : Actually she doesn't watch television a lot.

 A : Is she very quiet or is she rather restless?

 MP : Oh, she is restless.

 A : What do you mean? Can she sit still?

 MP : No.

 A : And how is it at night?

 FP : Then she is also restless.

 A : Is she restless in bed?

 FP : Yes, she tosses and turns in bed.

 Every one knows that there is a restlessness in this remedy. It is an anxious restlessness, worse at night, when they are alone.

 There is another strange thing which we see more often, namely that the mental symptoms remain if somebody changes to another remedy. For example, Rhus toxicodendron is also complementary to Arsenicum. Arsenicum is restless and anxious, and for example, after being overstrained they need Rhus toxicodendron.

 Or in Baryta carbonica. The main idea of Baryta carbonica is a lack of self-confidence, anxiety about doing something. You give the remedy, the reaction is wonderful, and after one year the patient has a taenia. It was a girl of 13, 14 years old and she came and said, "I have little pieces of a flat worm in my stool." And the parents said that she had changed in character. She was still insecure, didn't dare to do this or that, but in the meantime there were moments when she could be cheerful. I repeated Baryta carbonica: nothing. Then I took a look at the book of complementary remedies and to see which remedies were complementary to Baryta carbonica: Antimonium tartaricum, Dulcamara, Drosera and Silicea.

 She is blond, has thin hair and is relatively chilly. Which remedy did I give her?

 Audience: Silicea.

 A : Yes, Silicea, and 48 hours later a taenia of 3 m came out.

 (Laughter)

 And then I started thinking about what this could be.

 That's flexibility.

 You can say, "This is Baryta carbonica, and it remains Baryta carbonica, I won't go away from that remedy. I will prescribe a tea which will kill the worm or give YOMESAN for 3 days and the worm will be gone.

 But why does this child have a taenia?

 Her father, mother and sister, they all have small taenia, and they all eat the same ground meat. This means that her constitution is a constitution which is susceptible to this kind of disease.

 Our task is to get this taenia out and then we must understand what it means that these remedies are complementary.

 Another doctor from the Center also had a wonderful Baryta carbonica case. Everything improved on the remedy, only the chronic obstructed nose remained. It was worse with wet weather. He looked in the book for the relationship of remedies and because of the aggravation with wet weather and because it was complementary to Baryta carbonica he gave Dulcamara. Then the last complaint also disappeared.

 This is flexibility.

 You may wonder whether the first remedy wasn't the constitutional. Indeed there was an improvement on many levels, mentally she was doing better, but the obstructed nose remained. What does this mean?

 I don't know, but anyway, we see that Dulcamara follows Baryta carbonica, as it is written in the little book.

 A : At that time she slept with you.

 MP : Yes, when she had the febrile convulsions. She was anxious, especially because of the hospital. When they took X-rays she almost became hysterical; she was shocked from it. What I saw in the hospital at that time, the way the nurses were with her, the way they treated her, she surely got the anxiety from that.

 If a sudden anxiety comes up after somebody has been confronted with death or faced with a very big danger, what is the remedy?

 Aconitum.

 After an earthquake or if somebody has agony in a ski-lift or in an airplane you have to think of Aconitum.

 Who has an idea about what remedy it could be if somebody has singing in the ear or noises in the ear every time they fly? Maybe sometimes also palpitations, but otherwise no complaints. Who has an idea?

 (Silence)

 Every time they fly, when they go up high they have this, so we can think of a mountain remedy, complaints which occur when they are at a height.

 Audience: Coca

 A : Yes, right, Coca.

 A : Anxiety because she was not with you?

 MP : I don't know.

 A : But she might have had a fright from this.

 MP : She was there only three days, then I took her home, I know exactly. Maybe she got too many injections.

 A : So she has anxiety when something is expected of her and anxiety for anything dangerous. Or does she dare to do a lot?

 MP : In the playground she wants to sit on anything that turns, for example, the carrousel and so on.

 A : So she doesn't have any fear of heights.

 MP : She always goes to the annual market.

 A : Are you afraid on the carrousel?

 P : No.

 FP : She wants to go on the big roller coaster.

 MP : Actually I don't like it, and she only goes there with me, so I go because of her. In the meantime I've learned to enjoy it. And you, Tine? Do you dare to sit on all those things all by yourself?

 P : No.

 A : Does she always vomit when she eats something?

 MP : No. She doesn't need to eat anything in order to vomit. Actually she doesn't eat anything in the morning. If she doesn't have to go to school or doesn't have anything to do she doesn't vomit in the morning. When she goes on a trip with her class she doesn't eat anything and somebody has to go with her. She doesn't dare to go alone.

 A : And does she sleep alone now?

 MP : No, no. Sofie (her sister) has to sleep with her and the door has to be left open. No, no, surely she doesn't go to bed alone.

 A : And on holidays?

 MP : No, also not.

 A : Does she wake up at night?

 MP : No.

 A : Here it also says: likes fat. This is extraordinary for a child.

 MP : No, actually no fat. We like to eat French fries. I make them myself, I don't buy them. I also make the mayonnaise myself, and she likes to eat it. I make a salad with this mayonnaise and she eats it.

 The desire for fat is very prominent in this remedy, but they can also have an aversion. Sulphur, Nux vomica and Hepar also have a strong desire for fat, and Phosphorus is an addition. There are a few additions which you surely have.

 A : Does she like sweets?

 MP : Yes.

 A : Does she like ice cream?

 MP : Yes, a lot.

 A : And fish?

 MP : Yes, but no expensive fish. She doesn't like mussels or eel.

 A : Is it heavy on your stomach?

 P : No, I don't like it.

 A : Is it too expensive for her?

 MP : I don't know.

 A : You said that it was too expensive.

 MP : She says so. She says no expensive fish.

 A : Actually my question was whether it bothers her that it is expensive.

 MP : No, actually not. I don't think so, she's not interested in money.

 A : So no mussels or things like that.

 P : I'm just kidding when I say that I don't like expensive fish.

 MP : Actually she is not interested in money.

 A : Well, does she like fish or not?

 MP : She prefers codfish.

 A : And meat?

 P : I also like that. Beefsteak.

 A : What about sour things?

 MP : Actually we eat very few sour things.

 A : What about the little onions, silver onions?

 P : No, I don't like it.

 MP : No, she is not so fond of them. But she likes garlic a lot.

 You know that they can eat sour things, lemons, just like that.

 A : Here it also says that you have fear of thunderstorms. Is this true? Is this strong?

 FP : Not so much.

 MP : Yes, yes, it is clearly strong. For example, when she comes from school and she is in the street during a thunderstorm she is in a panic. When she is at home the panic goes away. The anxiety is only when she is alone.

 A : Is she easily cold or easily too warm?

 MP : Actually she seldom complains about coldness seldom, but in bed she likes it to be warm.

 They are chilly, but in bed they can be warm. Peculiar in headache is that in general they want to be covered up, but the head must be cool. They don't tolerate the heat of sun on their head. It is as if they have to be in the oven up to their neck and have their head in the refrigerator. This is very typical for this remedy. The case is clear, but you see that other homeopaths gave Lycopodium and Calcarea carbonica. And why?

 Because we think that Arsenicum must be restless and that it has to be an acute state.

 You can make a mistake when a symptom is underlined four times, like here "anxiety alone". Lycopodium doesn't have this and neither does Calcarea. Then comes the anxiety about ghosts, anxiety about this or that, and we go to another remedy.

 This was in April 1988 and one month later, May 1988 was the first feedback, and now June 1988, the second feedback.

 FEEDBACK (June 21, 1988)

 A : One month ago you received the remedy. Tell me, how did it go?

 P : I feel better. I'm not so anxious in school anymore.

 A : And how was it in the beginning?

 MP : I called you one week later, because she was doing very badly and the next day I called you again because she was still doing so bad. Two days later it was all right. She was doing much better and she was more quiet. She hasn't eaten anything yet, only drank some orange juice. I don't know why. Her appetite isn't all right yet.

 For example, yesterday she wasn't anxious all morning. She wasn't afraid of anything at all.

 A : So it is clearly better. Does she still have to vomit?

 MP : No.

 A : In the first week nothing was better.

 MP : Yes, and then I called you and said that she didn't want to go outside. At noon she came back and then she was doing better. Two days later it was completely different and since then it has been stable. No vomiting, not so anxious anymore. She can do things which she used to do, but I can't say she does everything she did before.

 A : Has she been ill since the remedy?

 MP : No, not at all.

 A : Did you feel anything?

 P : No.

 MP : She is much more cheerful.

 A : Optimistic?

 MP : Yes, she sings in the morning and in general she eats better.

 A : What do you mean?

 MP : Before she didn't dare to eat because she was afraid of vomiting everything, and now she eats well. On Sunday she was at school camp, alone.

 A : Before she didn't dare to go.

 MP : Before somebody always had to be with her, children from the neighborhood or somebody else, and this time she went alone.

 A : And did she eat there?

 MP : Yes.

 A : What about her sleep at night?

 MP : I don't know. When I sleep, I sleep. I think it is better.

 A : But before you knew she woke up.

 MP : Her father said that she tosses and turns constantly.

 A : All right. That's beautiful.

 MP : Yes.

 This was in June 1988. In May I gave her Arsenicum M. Then, on May 13, there was a call and my colleague wrote the following down: she is very pale, has headaches, very thirsty and is anxious. On May 13 he repeated Arsenicum M and up to now she has done well.

 This is a stable case. In the past history there wasn't any tuberculosis nor cancer and in such a case the remedy works a long time.

 Remark: ... (not understandable) ... Lycopodium and Calcarea.

 A : She had had them before already.

 Now for you this case is clear, because I pointed out the important things, but during the anamnesis when you sit in front of your patient and see all the symptoms you are confused.

 Question: ... (not understandable) ... to give Lycopodium and Calcarea together?

 A : No, no (is laughing). Then you have misunderstood me. This patient was seen by a colleague before and received Lycopodium in April and Calcarea in May. I saw her on May 22, and gave her Arsenicum. That's the story.

 We never give two remedies at the same time or in alternation. Sometimes we give a remedy one day, ask the patient to come back the next day and then we give him another remedy. For example, there are cases were you think: "Ah, that's Colocynthis!" You give it, the patient comes back the next day and says, "It is a little bit better, but ...", and you give Sulphur. This might happen when you get new information the next day, but this means also that the first remedy was not the right prescription.

 In very acute cases the remedy has to act relatively quickly and you must see a clear amelioration within 24 hours. Within this time a process in the direction of an amelioration has to be initiated or there must be an aggravation by means of an elimination reaction or a fever.

 Other questions?

 Question: What is the difference between fright and anxiety?

 A : Anxieties cause stronger suffering and often the people don't know for what. If somebody has fear of high places, then he has this fear in certain situations. Anxieties are often indefinite and go deeply. But it is a question of expression, what we determine as fright and what as anxiety, is a question of how the patient expresses himself. We always have to take the patient's words, the way he says it. For example, when he says, "I perspire at night and I can't sleep," this can have two meanings: he cannot sleep because of the perspiration, or he wakes up from perspiration. Waking up from perspiration is Conium, for sleeplessness because of perspiration there are a few remedies of which Sulphur is the most important. Try to understand the symptom right and take the corresponding rubric.

 Remark: Some people say that Arsenicum must be more chilly, but I haven't seen it in the video here.

 A : Yes, she is easily chilled, in general she is chilly and needs warmth. Arsenicum is chilly especially in acute states, also in chronic, but this does not mean that Arsenicum cannot be indicated in warm-blooded patients. I haven't had a case in which I had really good results with Arsenicum in a warm-blooded person, but apparently there are some cases. In Homeopathy you can never say "never".

 Remark: In my opinion, she was not so restless.

 A : Here she was not so restless. The restlessness of Arsenicum is an anxious restlessness. For example, when they are alone and become anxious they become restless.

 During the first consultation she was sitting on the lap of her mother, and then she was very quiet. The second time she was sitting near her mother. Why was she sitting on the lap of her mother the first time and only near her mother the second time? Maybe there was an amelioration so that it was easier for her to sit alone. 

 Surely she has become more independent. When she is sitting like that she isn't restless at all, but if she would have pain, it would be different. "Anxiety from pain", this is also Arsenicum.

 The appearance is also very important. Usually they are pale, very clean, neat, the hair is combed well, also their clothes are very clean and neat and often you find blue rings around the eyes. Sometimes they have swelling under the eyes, but the most important is the paleness, usually with dark hair, and the clothes are well chosen, very clean and neat. With such an appearance you have to think of Arsenicum.

CASE2

 Chronic gastritis, headaches

 Arsenicum album

 Case

 Boy, 11 years old

 September 4, 1985

 This is a boy who came for headaches, gastritis and vomiting. He was born in 1974 and came in 1985, so now he is 11 years old.

 This is a review, this means that the video was made after he was cured.

 A : The first time you were here was four months ago and for a long time you had suffered from pain in the stomach with vomiting.

 P : And headaches.

 A : Yes, and headaches. For how long had you suffered from the headaches and vomiting?

 P : I suffered with vomiting for a very, very long time. The headaches, actually it was nausea. When I ate something - I just couldn't tolerate food. When I had this pain in my stomach I just couldn't tolerate, then the headaches came back.

 A : You suffered with vomiting already for a long time. Since when?

 MP : Since his birth.

 A : Has he been hospitalized?

 MP : Yes. When he was two years old he was hospitalized.

 If somebody has been vomiting since birth, what disease do we think of?

 Pylorospasm (Spasmodic contraction of the pylorus ) . And what are the

most important remedies?

 Audience: Phosphorus.

 Audience: Silicea.

 Audience: Nux vomica.

 A : Nux vomica is the first remedy.

 Remark: No, with my children it was always Silicea.

 A : All right, with her children it was always Silicea, the first remedy is Silicea. And Phosphorus. But anyway make an addition of Nux vomica. There are two other symptoms for Nux vomica which you can see. Do you know them?

 Audience: No.

 A : I'm just thinking about another small thing. A female colleague had an Arsenicum patient with asthma who she took to the restaurant. The woman asked for lemon which she ate by itself and the asthma improved. We don't know this symptom. The amelioration from lemons or acids we know of what remedy?

 Of Ptelea. Mercurius has this also, but especially in Ptelea we find an amelioration from acids, but especially for symptoms of the digestive system. 

 You know Ptelea in hepatitis, acute and chronic hepatitis.

 So my colleague had an Arsenicum patient whose asthma was ameliorated by lemons. Remember that! 

 Now back to the pylorospasm. You find the corresponding rubric on page 483:

  STOMACH, Constriction, pylorus, of: Bry, phos

 A colleague said Silicea, but there are other additions: Nux vomica and China, China from Phatak.

 In Nux vomica children you might observe two other symptoms, one very high, and one very low.

 Audience: Frowning.

 A : Yes, you can observe this symptom, but there is something else, an expression of spasm. The main idea of the remedy is spasm, convulsions, so that the eyes are turned inward. 

 Look on page 1019:

  EXTREMITIES, Inversion, foot

 The convergent strabismus and the inversion of the feet are spastic expressions, just like a congenital hernia. An inguinal hernia in newborn children is often Nux vomica. Another spastic expression is an obstructed nose. Look on page 351:

  NOSE, Snuffles in newborn infants

NOSE,SNUFFLES,in new-born infants : Dulc., Lyc., Nux-v., puls., Samb.

 All this you can observe, the eyes, the feet, the hernia, all the places where spasms are expressed.

 Nux vomica is a very important remedy in children, a remedy which we don't think of easily, but it is very, very important. Maybe this state appears because of the medicines they had or because of the stress of the mother or I don't know what. I don't know exactly.

 A : The headaches appeared only lately - since when?

 MP : Since we were here, four months ago.

 A : So four months ago. Before you came here. Then the headaches have increased very strongly. Actually this was an attendant complaint of the nausea. You mean an extra symptom.

 MP : Yes. When he was four years old he had convulsions.

 A : How old are you now?

 P : I'm 12 years old.

 A : Further it says here: "When I think about it I have to vomit." What does that mean?

 That's a very important symptom. He says that he becomes nauseous, that he has to vomit even when he thinks about it. Look at the rubric on page 507:

  STOMACH, Nausea, food, thought of

STOMACH,NAUSEA,FOOD,thought of : Ars., bor., bry., chin., Cocc., Colch., graph., mag-c., mosch., sars., sep., sulph., thuj., zinc.

 There is another rubric under aversion, smell of food on page 481:

  STOMACH, Aversion, food, smell of

 STOMACH,AVERSION,FOOD,smell of : Ars., Cocc., Colch., Ip., podo., sep.

 Some of the remedies are identical. In which cases do we need these remedies?

 In vomiting during pregnancy. This peculiar symptom, nausea on smelling or thinking of food is very important. If you prescribe only on clinical symptoms you can go wrong.

 For example, I had a patient with cystitis. She came because of chronic rheumatic arthritis, swollen joints. First I prescribed Calcarea carbonica, it ameliorated a little bit, then Tuberculinum and maybe there was a slight amelioration, but the symptoms remained; then Sepia, because she had some leucorrhea and so on. One day she came with a terrible cystitis, and I had to choose between two possibilities: antibiotics, which I haven't prescribed for the last eight years or treat the case homeopathically. I decided to do the latter and first I gave her Cantharis. Sometimes I'm also a little bit lazy, and therefore I gave her the remedy with burning pain while urinating, and that is Cantharis.

 First it was a little bit better, but soon the fever went very high again. I visited her at home and there she said to me, "Doctor, my husband is Italian and he prepares dinners, Italian food. I just can't smell it." "What do you mean that you can't smell the food?" "When I'm lying on the sofa the smell of the food makes me sick." Then I asked her whether she had this symptom, becoming sick from the smell of food, for a long time. "Yes, I have always had it." "And why didn't you tell me before?" "Because I didn't know it was important."

 I gave her Colchicum M.

 Sarsaparilla also has nausea from thought of food and bladder inflammation, but she also had chronic swollen joints.

 After Colchicum M the fever came down, she became very tired and in less than three weeks the rheumatic complaints clearly ameliorated.

 That's why I regret that in Europe repertories are made on the basis of clinical diseases. They say, "In asthma you give this remedy, in cystitis you give this remedy, and so on," and therefore they will never be able to find Colchicum in cystitis.

 We know that in such a case we have to take the peculiar symptoms, and in this case it was the nausea from the smell of food. That's how I found Colchicum in this case.

 Another important remedy with nausea from the smell of food is Cocculus. This is another very important remedy in vomiting during pregnancy.

 And a symptom which often goes along with this is weakness while talking. What is the first remedy?

 Stannum. Stannum has also acute smell. Look in the Repertory on page 349:

  NOSE, Smell, acute: ... stann ...

 On the other hand if you look under weakness from talking, there you also find Cocculus.

 Weakness in pregnant women, usually with blond hair, nausea and vomiting, this is Cocculus.

 Another case  was very interesting, it was a woman from North Africa. She also couldn't smell the food because she became nauseous, and the only thing you could observe was very deep breathing. She had already received Ignatia, because we thought that the causation was homesickness, but she didn't react. Then we took the rubric on page 766:

  RESPIRATION, Deep, ameliorates: ... colch ...

RESPIRATION,DEEP,ameliorates : Acon., asaf., bar-c., cann-i., chin., colch., cupr., dig., dros., ign., iod., lach., meny., olnd., osm., puls., seneg., sep., spig., Stann., staph., ter., viol-t.

 Amelioration from deep respiration is a peculiar symptom.

 We gave her Colchicum and the result was very good.

 P  : Yes, when I think of food.

 A : When you think of food or smell food you have to vomit?

 P : Yes. When I smelled coffee I had to vomit.

 You see that Arsenicum is also there and Arsenicum is one of the remedies for anorexia nervosa. If an anorexia patient is disgusted by the thought of food don't forget Arsenicum.

 Don't start trembling if somebody with anorexia nervosa or deep psychological problems comes to you!

 Try to find the peculiar symptoms and search for them in the Repertory!

 A : Before he was hospitalized he had to vomit when he drank something.

 MP : No, actually everything. He couldn't hold in anything. Then we heard that he had acetonaemia.

 P : They said that milk was the problem.

 A : This problem has existed since birth and hasn't ever disappeared. Actually it has been worse lately, before he came here. Was there a period before the last four months that he didn't have any problems?

 MP : No, he always had something.

 A : Without any problems, headache, or abdominal pain?

 MP : No, there has never been a period like that.

 A : Therefore you waited four months before coming back to be really sure that it was gone. It is January 8 now, and you were here on September 4 last year, four months ago. At that time he received the remedy and actually since then he hasn't had any problems.

 P : On December 14, it was a Saturday, I got up late and went to music school. It was very warm and I got shortness of breath and became nauseous. I was nauseous all day.

 A : That was the only time. So we can say that you are doing rather well.

 FP : We tested it, we traveled and he didn't have any problems. Last summer we took a big trip and then it was very bad. He was completely exhausted from this trip. Anyway this time he did really well.

 A : The way he looks I think of a certain remedy. You also said that as a child he was rather restless. He never sits still.

 You see, first he does this and that, he is restless. You can observe this.

 Another symptom which hasn't been translated up to now, but maybe I haven't asked it yet: when he drank something, he had to vomit even after the slightest sip. Again this is an important symptom where you find Arsenicum again and also Bismuthum. Does every one know the peculiar symptom of Bismuthum?

 Bismuthum faints from stomach pains. Look on page 513:

  STOMACH, Pain, fainting, with: Bism ...

 Bismuthum also has the restlessness at night which drives him out of bed. The peculiarity is the amelioration while rubbing the back. If you think of Bismuthum in a patient you rub his back. If the pain ameliorates you can give him Bismuthum without any problem.

 Cadmium sulphuricum also has fainting from stomach pain. Cadmium sulphuricum is one of the most important remedies in patients with stomach cancer with coffee ground vomiting. If this remedy is indicated it is often palliative.

 A : He doesn't have blue sclera, he has dark hair, he is pale, and he is rather restless. When especially is he restless?

 FP : I think that is a characteristic of his, this restlessness. When he is reading he is quiet, or when he is drawing, and when he is playing; only in these three situations. Otherwise he is restless.

 A : He is also very precise in everything. That's also very typical for him. He wants everything to be precise and correct. He is very precise in getting along with others, also with his clothes.

 FP : Tell it yourself, we're talking about you. He can't tolerate if anything is wrong.

 P : If there is a dirty spot on my clothes, I change my clothes immediately.

 A : You can't tolerate dirty clothes, or even a small spot. It is not because others might say something, but because it bothers you.

 P : Yes, yes, I want it myself.

 A : This is another characteristic; he does not give things away so easily. He doesn't throw anything away.

 FP : There are things about which he can think for days. If he gives something away it causes stress inside him. Not that he is stingy , but it depends on the things.

 A : He holds on to things and it's difficult for him to let go of them, to let go of his personal things. Is this true also concerning his parents?

 FP : Yes, as a father I see that. For example, he doesn't say, "This belongs to me. " But when he gives you something he says, "This is important to me. This is a part of me." So, in this sense he does. He likes to give.

 A : He is also a little bit anxious. He doesn't dare to do much. For what and how are you anxious?

 P : For things which don't exist and for things which I don't dare to do.

 A : What don't you dare to do?

 P : For example, to ring at the door. I get blamed for it when the others run away. I don't like to do that.

 A : You don't dare to ring at the door of strangers. Why not?

 P : Because they become angry.

 A : You are afraid that you will get caught.

 P : Yes.

 A : Are there other things which the others do and you don't dare to do?

 P : To beg for something or to ask other people for something, I don't like to do that. I'm ashamed.

 A : Are you afraid to go somewhere alone? For example, to bicycle 5 km away from home or something like that, do you do that?

 P : At night?

 A : No, during the day.

 P : Yes.

 A : Or to perform a poem in class, are you afraid to do that?

 P : No.

 A : Are there other things you are afraid of or of which you become afraid?

 P : For example, I'm afraid of the teachers who are very severe in the refectory. If you say a word you have to write 5 pages. Then I'm afraid. If somebody says something to me I won't answer because I'm afraid.

 A : Are you ashamed then?

 P : No, I'm afraid that I will have to write 5 pages.

 A : Are you afraid in the dark?

 P : No, not anymore. Before I was.

 A : Are you afraid when you are alone?

 P : Actually not anymore. If somebody tells me something - my niece told me something about ghosts and manor-houses and fire which she had seen on television, then I became afraid.

 A : Are you afraid of death?

 P : To die yes, not of death itself.

 A : Have you ever seen a dead person?

 P : Yes, grandpa.

 A : Did it affect you?

 P : No. It was very sad, but otherwise nothing.

 A : You told me that he is very sensitive. What do you mean?

 FP : For example, he is sensitive about hurting somebody or if somebody else is suffering, then he feels the pain.

 P : I don't fight at school, I can't at all. I don't dare to fight with somebody else, or to hit him. I will never do a thing like that.

 A : Can you say he is an economical child? Does he like to save?

 MP : Yes.

 A : Is this remarkable compared to the other children?

 FP : Actually not so much. 

 MP : Yes, yes, I think so. For example, concerning sweets he compares himself with other children, whether they buy more sweets than he does or whether they have more money and buy other things.

 P : The others buy sweets at the bakery, I don't.

 A : Why don't you do that?

 P : I don't know. I don't think it's good if the parents don't know about it.

 A : You are rather honest towards your parents. But the honesty is because of the anxiety, to avoid difficulties at home.

 FP : He doesn't like to do things secretly. Sometimes he doesn't admit things, for example, if he finds 20 franks he won't buy French fries. He is too honest for that, very honest.

 A : He is very, very honest. But why do you save?

 P : I save so that I can go on ski-holiday in Switzerland with the class. I have to save 10.000 franks, but I have saved this amount already.

 A : And now? Do you spend money?

 P : I don't save money at the bank. I did in kindergarten.

 A : What do you do with the money now?

 P : I save, for example, to buy a remembrance for my parents. I also saved to buy a guitar.

 A : Do you play the guitar?

 P : Yes.

 A : Did you take lessons for that?

 P : Yes.

 A : Can we say that he has the tendency to feel insecure?

 FP : It's difficult to say. I don't know whether he was born with it or whether he has adopted it. He likes to be with us; not because he is afraid, but he searches for support, not so much security. At school he wants to be precise and neat and he wants to get very good marks. You might understand this as ambition. He doesn't do that because of the good results, but because he feels good then: I'm sure.

 A : What kind of job do you have? Are you a psychologist?

 FP : No.

 A : Actually you chose the wrong profession. You would have been a good psychologist. At school it comes down to security, to be good, to be secure.

 FP : For example, if he can't finish his homework we have to write a letter that he wasn't able to do that. Sometimes it happens because of circumstances, depending upon him. He becomes restless and he doesn't feel secure and then we have to write a letter to the teacher. By this letter he wants support from us.

 A : So again it comes down to security.

 FP : He says, "The teacher doesn't believe me", and then we have to write something. Without this letter he doesn't feel secure, and he wouldn't go to school without a letter the next day.

 A : So you must write a letter so that he has  proof for the teacher and then he feels secure. This is a very good description you just gave me. You told me that actually he tolerates the cold well and that he likes to eat chocolate.

 FP : Not anymore. In the last few months something has changed.

 P : I don't eat chocolate cakes anymore, and I don't like cacao so much either.

 In this case there are also many symptoms indicating Carcinosinum. He tries to please his parents, he likes chocolate and so on. The differential diagnosis often is not so easy. Surely there are many symptoms of Carcinosinum which we don't know of yet. We have found some clinical symptoms about patients where Carcinosinum acted very well, but the picture isn't complete yet.

 A : Has anything else changed?

 FP : No.

 A : Do you desire sausage or fat more?

 FP : Fat not so much, actually he has more of an aversion to it.

 A : He also likes spaghetti very much.

 FP : He likes biscuits and sweets less, and he has an aversion to fat.

 A : What about thirst? Is he very thirsty?

 P : No, not in particular.

 A : What do you drink? Cold or warm drinks?

 P : When it is cold outside I like to drink something warm, and usually when I'm thirsty I like to drink something cold. Usually I drink with small sips; before with large draughts, but mama says that I shouldn't swallow it fast, otherwise my stomach will hurt.

 A : But before you had the tendency to drink with large draughts.

 P : Yes.

 A : In what position do you sleep? Still on your abdomen?

 P : No. Now I sleep on my back and on my side.

 A : On the left side?

 P : Yes, on the left side and sometimes also on the right side.

 A : Usually you sleep on the left side. Were the headache and the nausea which you had before worse in warmth?

 P : Yes, then I had more problems.

 A : Aha, hmmm. When you were ill you were always chilly and when you had a headache you wanted your head to be cold.

 P : Yes, then it was better.

 A : All right.

 This was an example of a nice, friendly Arsenicum patient who does everything you tell him to do, who does not take risks, who you don't have any problems with.

 The big difference with Carcinosinum is that Carcinosinum likes to travel and in essence doesn't have this feeling of insecurity. This boy doesn't do anything which has a risk, or where he can cause any damage or when there is a danger, because he is so insecure.

 This case is also a relatively stable case. On September 4, 1985 he got Arsenicum 200, now it was Sac-lac, in June 1986 Sac-lac and then in April 1986, 7 months later, again Arsenicum 200. At that time the headache and the stomach pain had disappeared, but then he got an eruption in the face and dandruff. Dandruff is also an Arsenicum symptom. 

 You often see that the symptoms change, but the remedy remains the same.

 I gave him Arsenicum 200 again, and until December 1986 he was doing very well. He didn't have any anxiety anymore and the eczema was gone, only some dandruff remained. 

 Do you still have questions?

 Question: ... (not understandable at the beginning) ... of looking to the conjunctiva?

 A : Yes, the conjunctiva. In Carcinosinum and Tuberculinum they are rather blue; this is one of the physical symptoms of Carcinosinum and Tuberculinum. If somebody has blue sclera, it doesn't mean that he needs Carcinosinum or Tuberculinum now of course, but that he will need it one day.

 In Arsenicum also I have often observed a slight blue appearance of the sclera, but in order to determine them as blue they must be really clearly blue.

CASE3

 Anxieties

 Arsenicum album

 Case

 Boy, 10 years old

 In this case Arsenicum is not constitutional, but only a layer. 

 This boy was born in 1978, so he is about the same age as the first Arsenicum patient.

 A : The original problem - it was quite a while ago - was laryngitis and an allergic cough. This has really ameliorated.

 The first remedy, which he got with very good result, was Tuberculinum. Before he received Sabadilla, but it didn't do anything at all. He had Tuberculinum a few times, once in July 1985 and in July 1986 he got Tuberculinum 200 and afterwards Tuberculinum M twice. Then he came in January 1988 with this anxiety.

 A : Recently he came here very pale. How long ago?

 MP : The last time?

 A : Oh yes, one week ago. He was very pale - actually he still is, and he had blue rings under his eyes and was very, very anxious. Tell me, how did he behave?

 MP : Three weeks ago he didn't want to go to sleep. He was afraid of everything. I wasn't allowed to go out in the evenings. He always said, "I don't feel well." I didn't know why. He got thousands of things, he had to go to the toilet and so on, but he didn't have diarrhea.

 P : Is that a camera?

 MP : Yes.

 A : So he was afraid when he was alone. Did he sleep well?

 MP : He was always awake.

 A : And what did he do then?

 MP : He wanted to sleep with us.

 A : He was afraid at night. When did he get up?

 MP : Sometimes at 10:00 or 12:00 o'clock, later at night he got up, sometimes for three hours. If he fell asleep he woke again, wanted something to eat, a slice of bread and in between he had these anxious, panic states. Also at school he felt badly.

 A : It was a very dramatic state. I didn't make a video at that time, because it was so bad.

 MP : Yes, it was really bad.

 A : He also cried. It was very dramatic, he was really in a very bad state. What happened three weeks ago?

 If something like this occurs in a boy who otherwise isn't anxious, who isn't fastidious and so on, then there must be a particular causation. Now you could also send him to a psychiatrist, but there must be a reason for this new situation, and to understand, this is homeopathy.

 For example, if you usually have a sedentary life, writing at a desk, for example, and one week during the holidays you climb on the roof or cut trees in the forest and afterwards your shoulders hurt or you are completely stiff, then this is a Rhus toxicodendron state, no matter which constitution you are.

 MP : He visited somebody who had cancer with his aunt. He was really bad. When he left, this person shook hands with him and afterwards he got this anxiety that he might get it as well.

 A : You were afraid to shake hands with him. Why?

 P : He had cancer.

 A : And you knew this.

 P : Yes.

 A : And then you thought you might get it as well?

 P : Yes.

 A : He shook hands with you, you sat there for a little while and then you went home. Did you sleep the next night?

 P : Yes.

 A : Nothing happened immediately afterwards?

 If somebody is afraid of contamination we think of Arsenicum. Also Bufo is in this rubric. I added "afraid of AIDS".

 A doctor told me that he gave his son Bufo, because he was so afraid of getting AIDS, and this anxiety disappeared immediately after Bufo.

 I had another patient who was afraid of getting AIDS after an open injury. This was also a Bufo case.

 The anxiety about health is a very prominent symptom in Arsenicum, but Bufo has this also very strongly. If you ask more accurately you see that there is a kind of derangement in the sexual sphere, in the sense that they masturbate a lot.

 All right, Lachesis is also afraid of contamination and in women we also find a very strong tendency to masturbate. In Lachesis men I haven't seen this tendency up to now, only in women.

 A : How did it start?

 MP : It started gradually. He got pain everywhere, and then he became anxious of everything more and more.

 A : Has this man with the cancer died in the meantime?

 MP : No. But he really looked bad. Even my husband was startled.

 A  (to the patient) How did this man look? Did he look bad?

 MP  : He is paralyzed.

 (to her son) Was he lying in bed?

 P : On the couch.

 A : (to the patient) Tell me, are you afraid you might get it as well?

 P : (does not answer)

 A : You know that it is not contagious, but nevertheless you are afraid you might get it as well.

 P : Yes, I'm afraid to die.

 A : The anxiety about dying, this was actually the anxiety. Were you very much afraid?

 P : Yes.

 A : To die at night, to be alone? Did you feel insecure when you weren't with your mother at night?

 P : Yes, insecure.

 A : All right. Then we gave him the remedy. Was he chilly?

 MP : No, actually not.

 A : So I gave him the remedy one week before and when did he improve?

 MP : From Thursday on. He still had pain, first here, then there.

 A : He got the remedy on Tuesday.

 MP : Yes, and since Thursday he hasn't said that he felt bad.

 A : (to the patient) Do you feel better now?

 P : Yes.

 A : What else has improved? What about the anxiety?

 MP : He still doesn't go upstairs alone to sleep, but he slept all night.

 A : Before he didn't sleep at all. What else has changed? Can he go anywhere alone?

 MP : It is better now, but before he was always afraid.

 A : You saw that he had a very big aphtha in his throat.

 MP : Yes.

 A : But generally he is clearly better now.

 (to the patient) Do you agree? Do you feel much better?

 P : Yes.

 A : What about his appetite? Does he eat more?

 P : Yes.

 MP : He was eating, but he couldn't get it down his throat.

 In anxiety, accompanied by inability to eat, first of all you have to think of Arsenicum.

 Later he said that his grandfather died, the problem already started before. The fact that he was confronted with a man with cancer was another reason to go into an Arsenicum state.

 If you ask about it you will often find the reason for the Arsenicum state: an uncle or the grandfather who they were very close to died.

 Remark: ... (not understandable) ... lips are blue.

 A : The lips are blue, yes, this is also important. In Arsenicum you often see a bluish discoloration around the eyes, and also slightly bluish lips, but real cyanosis with shortness of breath is usually not Arsenicum, but a complementary remedy, Carbo vegetabilis.

 Voegeli says that you should never give Arsenicum in a real cyanosis. He means general cyanosis. But in local gangrene, in black, bluish discolored ulcers, in cyanosis of a finger and things like that, Arsenicum is also indicated.

 In burns with blisters the remedy is Cantharis, you know, but in burns of the third degree, when it becomes black, it might also be Arsenicum. But it might develop to Secale, as you know.

 I don't know whether I have already told you the story about the old man. He was 76 years old and one night they called me at 1:00 o'clock that he was dying. He was lying there gasping for air like a fish, very superficially. His feet and hands were icy cold. It was between 1:00 and 2:00 o'clock a.m. , and I asked what happened.

 He had diabetes, took tablets for blood pressure and so on, and was slightly sclerotic from good food. I didn't know what to do, but with a dying person with all the relatives around him you have to do something. So I went home and I got oxygen. On my way back I thought, "He is so cold, and they say that he is so restless, and it is about midnight ... This is an Arsenicum case." When I arrived I gave him Arsenicum, some oxygen and waited. I think it was about 7 minutes later when he opened his eyes, looked around and asked, "Where is my hearing aid?"

 In the meantime I called the cardiologist who was treating him and he said I should send him to the hospital, and so I called an ambulance.

 The patient was sitting there, he wanted his glasses and got up. He didn't want to go to the hospital, but nevertheless I sent him.

 Later I got a letter that his glucose was 800 mg % - at the moment he entered the hospital and was very alert. This means that he had already been in a hyperglycemic coma and Arsenicum got him out of this state.

 Afterwards they did all kinds of tests and he had a relapse. I gave him Arsenicum M again, he became better, he had another relapse and died.

 The first night I couldn't sleep from excitement. In these near death situations with paleness and coldness Arsenicum is often indicated. In Carbo vegetabilis it is more cyanosis, cold perspiration and they want fresh air. Arsenicum is dry cold and desires warmth.

 At the same time I had another case, I think it was in 1983 when a patient was suffering very much; at night he was very restless, wanted to get out of his bed, go to the toilet, then back to his bed and so on, and he always wanted to have somebody around. Arsenicum 10M was given and he died peacefully. It was a cancer patient with metastasis.

 A few months ago we had another patient with cancer and metastasis. She had very distended, blue veins in the face, was lying there and didn't react to anything. Which remedy did we give her? Distended blue veins in the face and unconsciousness?

 Audience: Opium.

 A : Yes, Opium. After Opium she came back to say good-bye and a few days later she died.

 Opium is another remedy for cyanosis and you know the snoring respiration of Opium. But Opium does not have cold perspiration, which you can see in Carbo vegetabilis.

 A : He is very thirsty and cannot eat, but was this because of the pain?

 MP : No.

 A : Did you have pain in your throat?

 P : No.

 A : You just couldn't get the food down.

 P : Yes.

 MP : It got stuck.

 A : And then he had to drink a lot.

 MP : Yes, he drank much, much more than before, and I thought that I would have to go with him to the doctor because of the fact that he was drinking so much.

 A : Together with the anxiety he had to drink cold drinks. All right. We will wait now, and it will improve every day. You see, he isn't afraid anymore.

 MP : Anxiety for three weeks is already a lot.

 A : You should have come earlier.

 MP : Yes, I should have known that it would go fast.

 Arsenicum took away his anxiety, he was really doing well.

 The state with the anxiety was very dramatic for him, you felt immediately death, anxious, anxious.

 After Arsenicum he got cracks in his ears. I repeated Arsenicum, but there was no improvement. Suddenly he started perspiring very strongly on his feet. His shoes were constantly wet and the perspiration was smelly. I gave him Lycopodium and Sulphur, without result, until I found the right remedy: Silicea. In February 1990 I gave him Silicea and in April everything was all right. The cracks disappeared, which he had constantly for two years, and which I couldn't cure up to then.

 Of course you can also say that these are only superficial symptoms and you shouldn't give anything else.

 Under Arsenicum he developed small warts on the footsoles, and because he reacted so beautifully to Silicea I waited. Will the warts disappear if I repeat Silicea? I don't know, but first I have to repeat Silicea before I go to another remedy.

 Why can't it be Thuja? I don't know, but it is possible.

 These are complicated cases. In these cases one remedy is not sufficient. In the course of time all these layers of tuberculosis, vaccinations and so on come up one day and the symptoms which he will develop then indicate the remedy.

 Question: ... (not understandable)

 A : Cracks behind his ear.

 Question: Is Silicea an addition?

 A: Is Silicea not there? Oh no. That was the reason why I didn't think of Silicea. It is a clinical rubric, that's probably the reason why it is incomplete.

 Before I told you that somebody who is working in the forest and gets pain afterwards needs Rhus toxicodendron.  Who can give me the corresponding rubric in the Repertory?

 Audience: In the generalities, "Pain, motion ameliorates".

 A : No. I had a patient who I cured from his chronic backpain with Sulphur. Then he came back after he had worked in the forest and got pain in his shoulder. I repeated Sulphur, without reaction.

 I said, "He must have been overstrained", and I asked when it hurt precisely. He said, "When I stretch my arm then it hurts." At the end Thuja came out, I gave him Thuja, but nothing happened. Then I thought of Rhus toxicodendron, and after one week all the pain was gone.

 Where do we find this in the Repertory?

 First his shoulder hurts, second it was from overstraining.

 Look on page 1019:

  EXTREMITIES, Injuries, shoulders, straining, after

CASE4

Arsenicum album

 Case

 Girl, 11 years old

 This is a very short case and you will recognize the remedy immediately.

 P : I have to vomit and then I'm anxious.

 A : So it started with an influenza?

 FP : No, it started earlier. Panic with vomiting. The last fourteen days they are hysterical attacks. Before it was more anxiety if she didn't want something. Now they are really hysterical attacks.

 MP : Very strong with trembling and, "Mama, mama!!" and very big eyes. There is real panic. Yesterday she came home, she ran away from school, came home without her jacket. She ran away without saying anything.

 A : You also said that before she was pink and round.

 MP : Yes, now she is still a little bit round in her face, but pale.

 A : And she has rings under her eyes.

 MP : She has really become thin. She also had fever and perspired a lot.

 FP : Yes, but that was when she had influenza 14 days ago.

 MP : And the last 14 days it has been all right again.

 A : Are there any symptoms left from the influenza?

 MP : No.

 A : But now the anxiety which she had before the influenza has become stronger.

 MP : Yes.

 A : It is a sudden panic. How is she when she has to go to school?

 MP : She can leave very cheerful and then suddenly she gets abdominal pain. Then everything is over.

 A : (to the patient) Where and how are you affected by this anxiety?

 P : When I get pain.

 A : You feel that you get anxiety, you have to vomit, and then you say, "I have abdominal pain." Where do you feel the anxiety? In your abdomen?

 P : Yes, yes.

 She feels the anxiety in her stomach together with vomiting and the inability to eat. Think of Arsenicum!

 Look on page 476:

 stomach,ANXIETY : Acon., am-m., ant-t., arg-m., arg-n., Ars., bry., calc-ar., calc-p., calc., cann-s., carb-v., caust., cham., chel., cic., cocc., coff., colch., crot-t., cupr., dig.,ferr-ar., ferr., gran., grat., guai., haem., hydr., jatr., kali-ar., kali-bi., kali-br., kali-c., kali-s., lact., laur., lyc., merc-c., mosch., mur-ac., nat-m., nux-v., op., paeon., plb.,puls., rhus-t., sang., sec., sep., sil., squil., stann., stram., sul-ac., sulph., sumb., tab., Tarent., ter., teucr., thuj., verat., vesp.

 

  STOMACH, Anxiety: ... Ars ...

 A : She doesn't always have to vomit. She doesn't have to vomit because of the anxiety, but the anxiety catches her stomach and then she has the impression that she has to vomit.

 MP : Yes, yes.

 A : The remedy is clear to me, but tell me a little bit more. Tell me something about her character.

 MP : She is papa's darling, that says everything. She is rather closed and very, very honest, actually too honest, a little bit too much.

 A : Honest in what sense?

MP : On all levels. Everything must be right. For example, in the examinations at school, with the division of the marks. Any normal child wouldn't say anything if she got good marks, but she does.

 A : Everything must be right.

 MP : Yes, to the last detail, and she can't lie at all.

 A : And this makes her anxious.

 (to the patient) If you have to do something which is not right, do you become anxious?

 This is not the same as in Causticum. Causticum doesn't tolerate somebody who is lying, but she doesn't dare tell any lies, because if somebody finds out she gets very insecure. For this reason Arsenicum doesn't dare lie.

 FP : Once she was anxious at school that her fellow pupils would laugh at her if she didn't know something. I overheard her, she knew everything. That's not the problem. Every evening she comes to me, she studies everything, she knows everything, French for example, but she is afraid to make a mistake, and that's the problem.

 A : This is a kind of fastidiousness, everything must be very precise.

 MP : The clothes, the school bag and also the food. If her little sister is smacking, or some food runs out of her mouth she becomes very restless and nervous. If her sister eats with her mouth open, she can't tolerate it at all.

 A : Her little sister must be very clean at the table.

 MP : Yes.

 A : Does she tolerate anything dirty?

 MP : No, no, it's not allowed.

 A : So she is not only precise in general, but everything has to be clean also, for example, her clothes cannot be dirty.

 MP : And her hair every morning (Oh je!!)

 A : Does she have any other anxieties?

 MP : Yes, I think she had a slight hyperventilation recently. At school she always wants to go outside. She says that she feels better outside, that she has to go out of the class. Actually she always feels better, when she can go outside, especially the last few days. And she says that one hand is cold and one hand is warm and there is numbness in one hand. And now she says that there is also numbness in one foot.

 P : Yes, when I'm sitting like this, with my legs crossed. At school I also had this.

 A : One hand was cold and the other warm?

 MP : Yes,  this symptom occurred briefly.

 P : Sometimes I have it in both hands.

 MP : Both?

 A : Was it noticeable that one hand was warm and the other cold?

 MP : Yes, yes, I noticed it myself in the car. Maybe she sat on one hand. Otherwise I didn't notice it.

 A : Does she have other anxieties?

 MP : Not that I know of.

 P : If somebody is ill; mama, papa or my little sister then I'm very worried.

 There is a difference between "sympathetic" and "anxiety about others". Sympathetic doesn't mean the same as when somebody has anxiety about others who are ill.

 It is important to differentiate these symptoms. 

 Arsenicum is not sympathetic, Phosphorus is sympathetic and has anxiety about others. Causticum is sympathetic, but doesn't have anxiety about others. Sulphur has anxiety about others, but is not so sympathetic, like Cocculus. It is important to ask about this precisely to see if it is anxiety or sympathy.

 A : Are there any other anxieties?

 MP : Nothing in particular.

 A : And when she is alone?

 MP : No. Only when she is ill she is.

 A : And in the dark at night?

 MP : Before she always slept with the door open and when I asked her whether she was afraid she said, "No, I'm not afraid," but the door had to be open.

 A : When she has these attacks she wants to have fresh air. Is she chilly or does she perspire?

 MP : Yes, her feet perspire easily. The perspiration doesn't smell, but her socks are completely wet.

 A : Can she tolerate the cold, or does she prefer it to be warm?

 MP : She doesn't like to wear a jacket. She is more warm than cold.

 A : Do you get cold feet easily?

 P : No, not excessively cold.

 A : Has anybody in the family been ill lately?

 P : Yes, Marijke.

 MP : She had pleuritis.

 A : When you are anxious what do you feel?

 P : I tremble.

 A : And what do you think? What are you anxious about?

 P : I want to be with mama and daddy.

 A : When you are anxious somebody has to be with you. You can't be alone?

 P : Yes, I can, but then I'm more anxious.

 A : So somebody has to be with you.

 MP : Yesterday I forced her to go to school. I told her, "Don't come home again, I am going to work, I won't be there, you will have to go to the hospital instead of going to school." She went to school and stayed there.

 A : She also has abdominal pain during examinations. When you are taking an examination are you anxious beforehand?

 P : Yes, I am.

 MP : For example, while shopping she comes back and says that she doesn't want to go in anymore, that she wants to stay outside, because otherwise she will get anxiety again. I think she is really hysterical. Yesterday she had to bicycle to the other side of the street and she said, "Mama, I won't survive this", really hysterical.

 P : Yes, yes, I imagine I will be dead immediately.

 A : What do you feel at the moment? Do you think, "I won't survive?" 

 P : Yes.

 MP : Yes, you could express it this way.

 A : She is very smart. She can describe it very well. Does she go to a nun-school? To the Ursulines?

 P : Yes, to the Ursuline college.

 MP : She also always corrects people.

 A : Yes, yes, it has to be perfect.

 MP : It must be completely perfect, everything must be perfect. When she has one mark less she holds on until it is right. It cannot be 9 points, it must be 10 points.

 A : All right.

 If you know all this it is easy to prescribe the remedy. Most people think that Arsenicum cases are terrible cases, but there are also many nice, beautiful people who need Arsenicum.

 FEEDBACK (November 21, 1989)

 A : Miss, you have a beautiful color.

 P : Thank you.

 A : Are you wearing make-up?

 P : No.

 A : Tell me, you took the tablet.

 P : It was a very good tablet.

 A : How did you do then?

 P : Well.

 A : She has become more friendly.

 MP : She doesn't correct others so often anymore, and the anxiety is less.

 P : Yes.

 A : The panic, that you had to run away, you don't have it anymore?

 MP : We thought about why she was anxious.

 A : Yes, tell me.

 MP : She is school sick. She doesn't like to go to school.

 A : This also belongs to this picture. Do you feel more like going to school?

 P : Yes.

 A : You say that the anxiety has gone, but she is still afraid.

 MP : Yes, she's still afraid of vomiting, but she doesn't do it anymore.

 A : (to the patient) Did you vomit?

 P : No, I didn't. Before I did, but not now.

 MP : And when she doesn't think of it she doesn't have abdominal pain anymore.

 P : When I was staying with grandma I had it once.

 FP : But in the evening she still has abdominal pain if something is expected from her.

 A : She is not so pale anymore. Did it go quickly?

 MP : No, it improved very gradually. In the meantime she had a one week holiday and then she was doing very well. It is still improving, but everything is not all right yet. At school she is too nice and every morning she is still afraid to go to school, but it has improved a lot.

 Also the falling hair has improved. Her hair has become very thin and now it doesn't fall out anymore.

 Her father is also in treatment in the Center, namely for Crohn's disease. Her mother said that he still has pain.

 The grandmother is also in treatment and with one dose of Arsenicum she is doing well. It was the grandmother who sent the girl to the Center for treatment.

 The differential diagnosis with Aconitum is sometimes not easy, but Aconitum patients are usually strong, plethoric people. Often Aconitum is complementary to Sulphur. The difference often lies in the constitution that's behind the acute state.

 In Aconitum usually it is a sudden onset, while in Arsenicum it starts when something is expected. In Aconitum usually the onset is a sudden fright.

Remark : In my opinion her appearance resembles that of Ignatia.

 A : I don't know. I can't say much about the appearance of Ignatia, because often Ignatia is a state into which anybody can come.  There are also a few constitutional Ignatia patients, but usually these are states because of grief in which anybody can come. Therefore I can't say much about the appearance of Ignatia.

 Remark: In Augsburg you showed a few Ignatia cases and there was a woman ..." (the end not understandable)

 A : Oh yes, I understand. But there is a small difference. They are nice, but Ignatia, concerning the make up, goes more in the direction of Sulphur. Sulphur exaggerates her make-up as you know, and often you can prescribe Sulphur on the smell and the appearance.

 The make-up of Arsenicum is very artificial and Ignatia lies in between Arsenicum and Sulphur. It is also a little bit too much (a case of taste), like everything is a little bit exaggerated in Ignatia. In this sense I understand your remark that the appearance of Ignatia resembles the one of Arsenicum.

 On the other hand Carcinosinum, Sepia and Arsenicum have a similar appearance, whereas Arsenicum is rather pale and has slight rings under the eyes.

CASE5

 Rhinopharyngitis

 Arsenicum album

 Case

 Boy, 16 years old

 This is a short, acute case

 A : When did it start?

 P : I have had a sore throat all last month.

 MP : And a cold. He has had this for a whole month.

 FP : For one month an obstructed nose, sore throat, and then again a runny nose.

 A : This goes on all the time, and then he got fever, three, four days ago.

 (to the patient) Show me your thermometer.

 P : (gives him the thermometer)

 A : At the moment you don't have fever.

 P : Usually I have it at night.

 A : Before he was very warm, he couldn't get cold enough, and now he is very chilly. Has it been like this the whole month, or only now?

 MP : He always has cold feet.

 A : Before he didn't?

 MP : No.

 A : This has also changed with his sore throat. He became chilly, especially his hands and feet.

 FP : Yes, he is very chilly. He comes home from school and says that it was very cold in class, that the central heating wasn't turned on.

 A : He has become pale. Before he had more color. He is complaining about a sore throat, but actually I can't see anything in his throat.

 (to the patient) What kind of pain is it?

 P : The day before yesterday I had a stitching pain in my nose and throat and now it is more my voice. I can't speak loudly.

 A : Now it has affected the vocal cords. The tongue is coated - no, the lips are coated, bloody crusts on the lips. Did you have vesicles before?

 P : No.

 A : Before he always wanted cold drinks, but lately he only wants warm drinks.

 FP : Every night he has a thermos with warm drinks near his bed.

 A : That's strange.

 FP : He drinks chicory coffee or sage tea, and he can't get enough of it, because it ameliorates the pain. Now he reads books about natural medicines, what he can do to treat himself. I had to buy all kinds of tea, four, five different kinds at the same time. He read that they are good for his throat.

 Do you know the rubric on page 392?

  FACE, Sordes on the lips

FACE,SORDES on the lips : Ars., colch., hyos., phos., Stram.

 Sordes means dry mucus, usually with black, died blood. These are not crusts, but mucus dried on the lips.

 A : He is also very anxious. He's worried by the slightest thing. "Shouldn't I have blood taken?" Shouldn't I be examined?" This is strange for a 16 year old boy, don't you think.

 FP : He didn't have this before.

 A : Do you think at the moment he is more tidy than before?

 FP : I don't dare judge this. No, actually not. He takes the treatment of his disease very seriously, but in other things he is very untidy.

 A : Is there anything else he takes very seriously?

 FP : Yes, his computer.

 MP : In his computer room he is extraordinarily tidy and precise; and also about diseases.

 A : (to the patient) Did you sleep well last night?

 P : I can't sleep at all because of the pain.

 MP : Yesterday night and the night before he slept badly.

 P : The day before yesterday I got up at 3:00 o'clock.

 A : The day before yesterday, not yesterday, when did you go to bed?

 P : About 9:00, 9:30.

 A : And when did you wake up?

 P : At 1:30.

 MP : About 1:15, 1:30. He got up and drank something.

 FP : First he stayed in his room for a while, but at 3:30 he went downstairs.

 A : He took a tablet at 3:30 because of the pain.

 FP : Last night he got up again.

 A : All right, that's clear. Today he takes the remedy, maybe one on Saturday also and on Sunday and then I want to see you again on Tuesday. Were you covered up well last night?

 P : Yes, I was covered up to my head, and I put a shawl around my neck. Also when I go to school I can't tolerate cold wind at all, especially not on my head.

 FP : That's typical. Before he always wanted to go out, and now he won't go even in front of the door, especially the last 14 days. I told him that the weather was fine and that he could go bicycling. When he goes out in the fresh air immediately he puts on his cap.

 MP : If there is a little bit of cold wind outside immediately he gets a cold. At school they laugh at him because he always wears a cap.

 FP : This is very noticeable lately. I want to tell you another peculiar thing. Lately when he gets fresh bedclothes or underwear he says that it still smells of washing powder. He has become very sensitive to smells.

 A : Do you have to vomit then?

 P : I can't tolerate it.

 A : Do you become nauseous?

 P : No, but the smell irritates my nose, it is very unpleasant.

 A : Before he got a remedy for his behavior and now it is more for physical disturbances, it has clearly changed, so that we have to give another remedy.

 This is a clear case. Somebody who was warm-blooded, becomes chilly suddenly, is covered up very well, desires warm drinks, is pale and has rhinopharyngitis.

 FEEDBACK (February 21, 1989)

 A : You were here the last time on Friday the 17th,  - no, on Saturday the 18th. You took the remedy and what happened?

 P : Immediately afterwards not much, but the next morning it was already better.

 A : You came back the same evening during night duty.

 P : Yes, I vomited.

 A : He vomited three times after the remedy.

 FP : He took the tablet here and immediately on our way back he vomited.

 A : Without having drunk anything, so it was not particularly after drinking.

 FP : And then he vomited twice more.

 A : Did you take another tablet?

 P : No.

 A : All right, you didn't take anything more. How was it the next day?

 FP : First it was a little bit better but in the evening it was clearly better.

 A : And are you doing well now? Your lips are clear, the bloody crusts are gone, how is your throat?

 P : It's very well.

 A : Has the pain gone?

 P : Yes, it is gone. I only have to clear it a little bit.

 A : Are you still so chilly?

 P : No.

 A : The last time he was cold easily. Is it better?

 P : Hm, yes, hm. I haven't noticed it so much anymore. I also don't have any pain.

 A : Have you been to school?

 P : Yes.

 A : Well fine. Now it is all right, isn't it?

 (to the parents) Do you think it is better?

 MP : Yes, much, much better.

 A : Then it is all right, and we will wait to see how it will develop.

 MP : In the morning there is still green discharge from his nose.

 A : Before it was more allergic, it was watery, and now he produces mucus and brings something out, and he was very anxious, right.

 FP : Now he is more quiet at night.

 MP : He also stays in bed longer. Before he always had to get up. The same day he got the remedy he was more quiet.

 This was an acute case, and when you take the characteristics together you easily find the remedy: the restlessness at night driving him out of bed, the chilliness, the desire for warm drinks and so on.

 Remember that the discharges in Arsenicum are usually irritating, excoriating, and burning. And if anybody likes to put something warm on it it is surely Arsenicum.

 Burning pain, whether in the eyes, the nose or the aphthae indicates Arsenicum very strongly, and when the burning pain is ameliorated by warm water it indicates Arsenicum.

 Burning pain, with diarrhea, inflammation of the nails and burning pain ameliorated by warmth, is Arsenicum.

 

CASE6

Arsenicum album

 Woman, 52 years old

 A : How old are you?

 P : In December I'll be 53 years old.

 A : You came the first time in 1985.

 P : Yes, I must have been about 49 years old.

 A : At that time you said, "I have had anxiety since I was 33. "

 P : Yes, it started at that time, very gradually.

 A : You took TEMESTA (a tranquilizer).

 P : And something else, but I don't know what.

 A : These were rather heavy psychopharmaceuticals.

 You can observe black hair, paleness, swelling under the eyes and she is dressed very well.

 P : When my aunt came to live with me it came back. As a child I was afraid of dead people.

 A : Already as a child?

 P : Yes, I already had it as a child. It went away gradually as I became older. When I became older it lessened.

 A : Where did it actually come from?

 P : My father was ill often, and he always talked about death. He knew I was afraid of it and at the slightest thing he said, "Anneke, I will die." I became terribly anxious. He might have influenced my character by this.

 A : You were very much afraid to die?

 P : Yes, yes.

 A : Is he still alive?

 P : Yes, yes, he's still alive. He is 80 years old now and very healthy. When I got older I didn't have the anxiety anymore. As a child I liked to walk in the graveyard and I also liked to go to funerals. Because of my aunt, who I've taken care of at home since I was 33 and who has been ill very often, it gradually came back. Later she went back to her own house, but the anxiety remained, I was always afraid that she would die.

 A : But that didn't have anything to do with it, did it?

 P : When she was gone I still had the anxiety.

 A : But you also had it as a child.

 P : Yes, fear of dying.

 A : As a child you had other anxieties, didn't you?

 P : No, I didn't. I didn't take a lot of risks. Unusual things or things which were not right I didn't do. I went everywhere, but to do something risky, like climbing high in the trees or things like that, I never did. I thought I might fall and then I would die. No, no, I didn't do anything like that. I only did normal things, but never anything risky. In the evening when I was at home I closed and locked everything very well.

 HP : At the age of 13 or 14 she took a lot of risks.

 P : At that time I was also anxious, but I had to go on and so I did. When I stood on the podium and sang, I got weak knees, but nevertheless I sang. Usually I had anxiety beforehand, and when it was time to sing, the anxiety went away. The moment I started singing the weak knees and the anxiety was gone. I still have the anxiety beforehand and about everything which could happen. Beforehand I'm always very anxious.

 A : So you have always had this anxiety?

 P : Yes, yes.

 A : And when something is expected from you?

 P : Yes, yes, precisely then. Now it is a real anxiety, before it was not so strong.

 A : Is everything cleaned up in your house?

 HP : Yes, actually it is very clean. That's a fact, you can't miss it, there cannot be any dust at all.

 You know the rubric on page 72:

  MIND, Rest, cannot, when things are not in proper place

MIND,REST, cannot, when things are not in proper place : Anac., ars.

 Before they go to bed they have to do the wash.

 HP : When I come home everything is tip-top.

 A : For example, when you have visitors in the evening and you have had a Dutch gin or things like that, can you go to bed without washing the dishes?

 P : Yes, I can.

 HP : Lately she hasn't been as precise, about cleaning and washing, but still everything has to be tip-top. Otherwise she can't sleep 9 out of 10 times.

 P : Also as a child I was like that. At school everything was in order. I had a table with a compartment for books, sometimes we had a surprise check and mine was always in order. I was known for that at school. I was always very neat and everything was very, very beautiful. Everything had to be neat. I was like that as a child.

 A : By character you are very ...

 P : Yes, I want to clean up even the smallest things.

 A : Actually you don't take a lot of risks.

 P : No.

 A : You don't take any risks.

 P : No. Actually I never had to take any risks. 

 A : For example, financially?

 HP : She can do better than I. She can do something which I wouldn't even think ... On the other hand she is economical.

 P : Yes, I'm economical, but when I like something I buy it. When I don't have enough money, I don't buy anything.

 A : You don't throw your money out of the window.

 P : No, no, I don't buy everything, I put some money aside. We always pay for everything, we never buy on credit.

 A : Have you ever had financial problems?

 P : No. That's not the reason for the problems.

 HP : Both of us worked very hard.

 A : What did you do?

 P : I have worked in the factory for seven years and afterwards I cleaned at my neighbors. I always went home so that I was at home when my child came home from school.

 A : Your child's clothes are always very well taken care of.

 P : Yes, yes, it must be like that.

 HP : Even when she cleans she wears the finest clothes.

 A : If you look at her she wears clothes which are a little bit special.

 HP : Yes, a little bit fine, but she is not particularly dressed up. When she is dressed normally it still is a little bit fine. It is perfect and a little bit beyond normal clothes.

 P : At the age of 14 I worked as an au pair girl, in a high ranking family in Brussels and I was raised as if I was a girl from a good family with them. The lady could do everything, she worked hard, and I learned everything there. I lived like a daughter in their house and I felt very good. I also do a lot myself, I can do everything, I knit a lot. I knitted this myself.

 A : Let's show this on video. 

 (P shows the knitting)

 That's incredibly well knitted. The stripes are completely straight, not even slightly uneven, there is no fold in it at all. It is like new, and you have had this quite a while.

 P : Yes.

 A : Not one fault.

 The quality of the clothes is very good and the material is silk, something very fine. Not raw wool, no, fine silk. You are afraid to touch such women.

 A : Something else: in the evening the door has to be closed.

 HP : Everything that can be locked has to be locked.

 A : What do you mean?

 HP : The kitchen door must be locked securely, the door to the living room and the backdoor.

 P : Yes, it's a habit. It is not an anxiety, but a habit. But it must be locked securely, only the door to the bedroom can be unlocked. Inside, the doors can be left open, but not the outside doors.

 A : Do you have anxiety, and about what?

 P : Actually I don't know myself.

 A : Has anything been stolen?

 P : No, not yet.

 HP : In the neighborhood they broke in once, and when she reads the newspaper and things like that she becomes restless.

 P : Then I wonder what I would do if they broke in here. What should I do?

 A : Do you ever look behind your wardrobe or things like that? Or under the bed?

 P : Yes, I did as a child.

 You know the rubric "fear of robbers". They come home and they look under the bed to see whether anybody is there.

 P : I was never alone at home. My parents were always there.

 A : Did you ever dream of thieves?

 P : Yes, not so long ago. It was bad. I dreamt that we were gone and when we got home my husband stayed downstairs. I went upstairs and there were thieves in my bedroom. I wanted to scream, but I couldn't. I wanted to scream, and scream and then my husband woke me up because I screamed terribly.

 Look on page 33:

MIND,DELUSION,THIEVES,night : Ars.

 MIND, Delusions, thieves sees, night

 Further there is the rubric:

 MIND, Delusions, thieves, that house and space under bed are full of

 HP : I had to wake her up, because she was like a person  breathing for the last time. It was terrible to hear.

 P : I don't know where this came from. When I woke up I was very anxious and it lasted a long time. It was a very anxious experience. I couldn't scream, had no voice and so ....

 A : You said that you didn't have to be afraid at home because you were never alone. Weren't you afraid when you were alone in between, when your husband was gone?

 P : Well yes. I was at home, it had to be like that. My husband had to go to work.

 A : In 1985 there was a period when you were afraid of being alone.

 P : Yes, yes, actually my husband wasn't allowed to go away from home.

 HP : At that time it went too far, I thought.

 P : I came to you because the tranquilizers didn't help anymore and my husband thought it went too far.

 HP : She could sleep when taking the sleeping tablets, but after a while they didn't help.

 A : At that time you were also afraid to go to the doctor and afraid to go shopping.

 P : Yes, yes, especially for that. I didn't dare go out on the street anymore. I just stayed at home.

 A : What was the causation?

 P : I don't know.

 A : And when your husband was with you?

 P : Then it was better. But later I was anxious even if somebody stayed with me. I had to go back home, I didn't feel well anymore, I was very nauseous because of the anxiety.

 A : Also when traveling, on holiday?

 HP : No, no. She couldn't travel. Home, home, home; as soon as we drove somewhere she wanted to go back home immediately.

 P : When I see these long queues at the railway station, so many people, I'm already afraid. I also don't dare to fly.

 A : Why don't you go on holiday?

 P : It doesn't appeal to me. I think that it's really good at home. We can't have it better anywhere. We live in the forest. We're at home, I can do what I want. I don't know what else I want to do. We went away for three days, in the Ardennes, but it just doesn't appeal to me.

 A : When you were in the Ardennes, were you afraid then?

 P : When I was there, actually not, but I was beforehand. I wonder what I really want.

 A : And when you were there did you think of home?

 P : Yes, of course especially of my dog. The little animal had to go somewhere else and that's not good either.

 I remember another woman who also had this refined appearance. There is another remedy which has this type of refinement on the same level.

 

Audience: China

 A : Yes, very good, China also has this refined, aristocratic, maybe a little bit haughty appearance. Here you don't find so much the haughtiness, it is more prominent in China. They underestimate other people and so on.

 With such a refined, distinguished, somewhat aristocratic appearance you have to think, from what I have seen in practice, about Arsenicum and China.

 A  : Your husband is a driver. He drove a truck. Was this the reason for your anxiety?

 P : No, actually it wasn't.

 HP : It's strange she wasn't afraid. When I said that I would be home on Friday at 6:00 p.m.  and I came home one or two hours later then she was worried. I couldn't call her beforehand, but nevertheless she was not so restless. That was strange.

 P : My son will be 26 soon and when he was gone it was terrible! Then I was restless.

 HP : I was restless also, especially, when he got his first car.

 A : Was it worse with her?

 P : He was restless too, but it was worse with me. I never showed it, but....

 A : The second thing you said was that you had a fear of death and that you won't look at a dead person.

 P : As a child I did, but now ... I went to the graveyards and the church, but dead people? No, no. Before I did, but I'm always a little bit afraid.

 A : If they tell you that somebody has died do you become anxious?

 P : Yes, I become anxious.

 A : Death is a terrifying thing for you. You say, "I live in the forest, there is good air, why should I go somewhere else?" Is your health so important to you? If you go somewhere else and the food is different, are you worried about your health then?

 HP : Not in this sense. But when she coughs it becomes worse. If she coughs once she becomes afraid. I must be half dead before I'll get anxious, but she only needs to feel the slightest thing and she becomes anxious.

 A : At night you weren't afraid so much, but in 1985, you woke up at 2:00 o'clock.

 P : I woke up, but I fell asleep again. Always after midnight, about 2:00 o'clock at night.

 A : At that time you were also afraid because of your heart.

 P : Yes, I had heart palpitations.

 A : When did you have them?

 P : When I had to do something.

 A : Do you always need to be busy or can you sit somewhere quietly?

 P : Oh, I can sit quietly as well.

 A : But I see your husband laughing when you say this.

 P : Well yes, I always worked very hard. If I don't have any work I do handwork or I read, or sew or knit. I like to read a lot.

 A : Does she lie still in bed?

 HP : Yes.

 A : Also when she was anxious?

 P : Externally I'm rather quiet, you don't see it. The restlessness is inside.

 A : Then you also said: I'm a very chilly person.

 P : I'm always suffering from the cold.

 HP : It's a family trait.

 A : The whole family is freezing cold.

 P : My father also.

 HP : Her father is 78 years old and I can't sit a quarter of an hour in his room, it's too hot for me.

 Her father always says, "Anneke, I'm going to die." Maybe he really is afraid to die, but he is still alive and he is 83 years old. Maybe her father also needs Arsenicum.

 This woman is one of the most beautiful constitutional Arsenicum patients I've seen up to now. Since 1985 she has been completely stable and she has had many more Arsenicum symptoms.

 P : Yes, he is always very cold and I can't stay in his room for a quarter of an hour. I'm not that cold, but I'm not as old as my father. I'm not as chilly yet.

 A : Then further: what about your food desires? What do you desire most?

 P : Everything, I eat everything; I desire one thing more than the other, but I don't have any problems.

 A : What do you desire most?

 P : Sweets.

 A : In which form?

 P : Chocolate, biscuits and cakes.

 A : Biscuits with something?

 P : Yes, with sour cream.

 HP : Sweets in the form of pastries, sweets and chocolate, so little dainties.

 A : Chocolate?

 P : Yes, yes.

 A : Do you like it very, very much?

 P : Of course I don't overdo it with anything. Always a little piece. I don't have such a strong desire. I take a little piece. I never eat a whole bar, no, no, no, I don't. As you sometimes read, one kilo of pralines a day, that's not for me.

 A : That is your first choice, sweets.

 P : Yes, yes.

 A : What is your second choice?

 HP : You can't have your second choice.

 P : Yes, coffee.

 A : Oh yes. Warm or cold coffee?

 P : Hot, hot coffee. A good cup of coffee, hm.

 A : Cold drinks?

 P : No, not so much.

 A : And your tea must be rather warm.

 P : The soup also, everything must be rather warm.

 A : Do you drink with sips?

 P : Yes, so that I can enjoy the taste. Sip by sip.

 A : What is number three?

 P : You know this better than I do.

 A : Tell me.

 P : Soup.

 A : So you like to eat in a good restaurant, soup in a good restaurant. You like to go out to eat.

 P : Yes, in a gourmet restaurant. Of course it must be all right.

 A : Can it a little be spicy?

 P : Yes, yes.

 HP : It can be sweet also.

 P : Yes.

 HP : My wife doesn't like as much highly seasoned food as I do.

 A : (to her husband) I can see it in you, you prefer the food very strongly spiced.

 HP : Yes, yes.

 A : Your constitution is clear. What about fatty things? If you have a cutlet with a lot of fat ...

 P : No, I don't like it so much. I also don't take gravy with the meat.

 A : Why not?

 P : I don't know. I don't eat everything.

 A : Is this because of your health?

 P : No.

 A : Are you sure? What about alcohol?

 P : Sometimes a glass of wine.

 HP : Yes, but that's all.

 A : What about the taste?

 HP : There are women who don't want to drink wine.

 A : A good glass of wine?

 P : Yes. I can tell you exactly whether it is a good glass of wine or not; one or two glasses and then I stop. I don't like strong alcohol, it doesn't taste good.

 A : But wine does.

 P : Yes, yes, a good glass of wine, white or red, it doesn't matter.

 A : What do you put on your bread? What do you like?

 P : I like something sweet, marmalade the most. I prefer marmalade to meat.

 Wine, whiskey, brandy these are all Arsenicum symptoms, you know this.

 A : What kind of bread do you prefer?

 P : Black.

 HP : Rye bread, whole-wheat bread.

 A : No white bread?

 P : No, very little white bread, but with butter, with a lot of butter. Then actually I don't need anything with it. So, a good cup of coffee with bread and butter. Of course now I don't drink coffee anymore.

 A : And fruit?

 P : I like it a lot, I eat kilos of fruit a week. My husband eats very little fruit.

 A : What kind of fruit?

 P : Everything.

 A : Sweet or sour?

 P : No, not sour, no lemons. I drink tea with lemon yes, or hot water with lemons when I have a sore throat and with a lot of honey, but otherwise not.

 HP : Oranges, grapes and so on, but not sour.

 P : No, not sour.

 A : Sweet fruit?

 P : Yes.

 Desire for fruit, and acid fruit, don't forget this.

 A : Is there anything you don't like at all?

 P : Cheese from Brussels.

 A : Does it stink too much?

 P : Yes, it stinks.

 A : You have a good nose?

 P : Yes, very, very good.

 A : Are you easily disgusted?

 P : Yes, very much.

 A : So when it smells a little bit you are disgusted?

 P : Yes, yes, very easily.

 A : Besides cheese is there anything else you don't like?

 P : Nothing in particular, one thing more, the other less. I have tried to eat the Brussels cheese, but I can't eat it.

 A : What about meat?

 P : No, I don't eat it much, only a little piece. With potatoes I like some meat, but a little piece. When I eat a little piece it is all right.

 A : Once you said, "My feet are too  warm."

 P : I still have this. I put them out of the covers frequently.

 A : Your feet?

 P : Yes, yes, my feet.

 A : Actually you are chilly, but you put your feet out of the covers. Where are they warm?

 P : All over. I have to cool them down, they are so warm.

 This is a very important symptom in the differential diagnosis with Sulphur.

 A : Are they burning?

 P : No, they don't burn. I have the feeling they are warm and they have to cool down.

 A : How long do you put them out of the covers?

 P : Only a few minutes, then it is all right.

 A : Both feet?

 P : Yes, both. Usually I put one out, sometimes both.

 A : Is this the only place you are too warm?

 P : Yes.

 A : Do you tolerate the sun on your head?

 P : Yes, rather well.

 A : Can you sit in the sun with your head uncovered?

 P : Yes.

 A : Do you get a headache?

 P : No.

 A : Can you eat ice cream? Very cold? Do you get problems?

 P : No, no.

 This is a keynote. "Headache after ice cream", is a keynote for Arsenicum and Pulsatilla.

 A : You didn't only have anxiety, but also rheumatism. You stopped taking the tranquilizers and the anxiety improved clearly. It helped. You reacted immediately to the first remedy.

 P : The first tablet helped me enormously.

 A : Sometimes we have had to repeat it, but now everything is all right.

 P : Yes, I'm feeling very well. If my life continues on in this direction I will be very satisfied.

 Question: Can you say something about the differential diagnosis between Arsenicum and Kali arsenicosum?

 A : No, I don't have enough experience. I only talk about remedies I know well and which I understand. Indeed, I have had some Kali arsenicosum cases, but I don't see a clear difference.

 With these remedies we are in a state in which we can prescribe upon peculiar symptoms and keynotes, but the differentiation on the mental level is still very difficult.

 Remark: If I remember well, Ananda said that the problems in Kali arsenicosum are more on the physical level and there is less anxiety.

 A : Yes, it might be, but I don't know. It would be good if she could show us four, five of these cases, where we can really grasp that kind of thing. On the basis of only one case you can't talk about a mental picture. I would like to see some more cases, in order to see what symptoms always come back, whether there is a line going through all these cases. Maybe the future will make these cases clearer.

EXTRA

Arsenicum cases which I have seen, the patients were very anxious, had to sit upright, somebody had to be near them, they were restless and had to get out of bed.

She was with her brother when he died, she told me this the first time on February 12.  In general this was a clear Arsenicum picture. I don't know what Carcinosinum did, anyway Ignatia and Carcinosinum pushed the Arsenicum picture to the surface.

She had an aversion to the smell of food, nausea from the smell of food, and didn't want to eat anything at all. This was a clear, acute Arsenicum case.

But don't forget that Arsenicum can develop into Sulphur, both remedies are complementary.

 You cannot yet decide upon this symptom. Therefore I also said that Arsenicum is almost always chilly. She is also chilly, but she has hot feet. The restlessness, the anxiety which drives her out of bed and because I knew that she already received Arsenicum I felt more secure with Arsenicum.

Suddenly, at night thoughts about the death of her mother come into her mind and she doesn't want to be alone. You clearly recognize Arsenicum, fear of being along and thoughts about death.

Which is the first remedy we think of when someone tells something about burning ? Arsenicum. Arsenicum for burning pain, but the modality of Arsenicum is an amelioration by warmth. When you see this very strong burning pain, whatever it may be, also in panaritium or another inflammation and it improves by warmth, for example, in necrosis after burn wounds, it is only one remedy: Arsenicum.

 

Case7

A physician aged forty-three years has intermittent fever with these characteristics :

 Type of chill : (1) Tertian; (2) severe shaking.

 Time of chill (3) 1 a.m. 

 Concomitants of chill : (4) coldness in the back; (5) pain in the extremities; (6) vomiting; (7) relief from external heat.

 (5) Chill short, about half an hour, fever following several hours.

 During the fever : (9) sleepless.

 During apyrexia : (11) extreme weakness; (12) anorexia; (13) headache.

 Arsenicum alone covers all these symptoms. Pulsatilla lacks Nos. 7 and 11. Nux vomica lacks Nos. 3, 4 and 9. Natrum muriaticum lacks Nos. 3, 7 9 and 10.

 Arsenicum album cm Fincke, one powder at 10 a.m. 

 On the second night there was slight fever in the evening without chilliness. He awoke at I a.m.  in a profuse sweat.

 PAGE 16

 Health was quickly established without any more chills or medicine

EXTRA

- He says, that he is insecure and if you look to the essences of Vithoulkas you say, "Insecurity is Arsenicum.

 - " This is the essence ofArsenicum.

 - Vithoulkas relates everything to insecurity in Arsenicum.

 - If we take it just like this, without analyzing, we will miss.

 - He is chilly, desires fat, almost everything indicates Arsenicum.

- Which remedy has this? He doesn't dare to go somewhere alone, he needs somebody with him.

 - This is Arsenicum and Kali arsenicosum

Another  case of vomiting after drinking little water

- He doesn't want to have anybody around, so Arsenicum and Phosphorus are out of question.

 

Do you remember the patient who had a glycamie of 800 mg%, the man who was nearly dead and whom I send to the hospital? No? It was the husband of an old friend. She called me at night and said: "Doctor, my husband is dying!" I went immediately to her house and saw the man lying like a fish, with a superficial respiration, icy cold, the legs and the whole body was icy cold. It was 1.30 at night and I asked her what happened. She said: "Yes, he was so restless and now he is in coma and is only breathing superficially. I saw that he was dying and asked myself what I should do. I was desperate because it was clear that this man could be dead within a few minutes. I went back to my car, got the oxygen and at that moment I noticed that he was very pale - not blue - and was icy cold; dry, no perspiration. This must be Arsenicum in the differential diagnosis with Carbo vegetabilis. In near dead situations you need near dead remedies: Opium, Antimonium tartaricum, Carbo vegetabilis, Arsenicum, to get the patients out of their situation

 I came back and I gave him Arsenicum 200 in his mouth, gave him oxygen and was sitting for a few minutes beside him

---------

I forgot to tell you this: desire warm drinks is also Arsenicum, Arsenicum is one of the most important remedies in acute states.

 

CASES