Words: Dr Frank GRUBER
Mary is a 42-year-old mildly retarded woman who came to my office with her sister with a chief complaint — of epileptic seizures. She was taking Tegretol 400mg each morning and had been on that medication for about three years. Prior to that she had been on 4-5 different seizure medications — in the attempt to control her seizures. The medications, including Tegretol, did not control the seizures.
Earlier in her life Mary had grand mal [generalised fits] seizures. Currently, they are focal seizures which consist of twitching, starting in the left hand, moving up the left arm and continuing upwards to the face, especially around the mouth and eye. They are usually on the right side of the face. She usually does not have twitching in the legs and does not lose consciousness during these types of seizures. She does still occasionally have grand mal seizures during which she does lose consciousness. The seizures last for a minute, or so, and leave her with no adverse effects afterwards.
The seizures started at age 14, right after menarche [first occurrence of periods]. While they can occur at any time of the month, they continue to be aggravated by the periods. They worsen primarily before menses, or periods, but can also be somewhat worse right after. They are not so prevalent during the menses. They are worse during stress. The menses are not regular, but never occur more than once a month.
Mary also has scoliosis [sideways curvature of the spine] and has a Harrington rod to support her spine. She has a history of very mild osteoarthritis of the left hand and both ankles.
Mary is an affable, pleasant woman who seems eager to please. I meet her in the waiting room where she is sitting reading a paperback book. I ask her what she’s reading and she mentions that it’s a romantic novel. She responds easily to my questions; she also volunteers information to the point of being quite chatty and talks loudly in an animated way.
It seems that Mary was premature and that she almost died at birth, although neither she nor her sister know the details. They just know that Mary “didn’t get enough oxygen in the womb.” She was slow learning to walk and talk and was always in special education classes in school.
Mary lives with her mother, who has been ill for a long time. She essentially waits on her mom hand and foot. Mary is normally easy going, but can get stubborn, or even have tantrums if she doesn’t want to do something. She can be sensitive and easily offended. She watches children’s TV shows.
Mary reads mostly romantic novels. She has three bookcases full of paperback romance novels. I note that while I am putting symptoms into the computer and shift attention from her for a minute, or two, she opens her romance novel and begins to read. She describes the novels as “very racy” and smiles. She denies masturbating.
She has difficulty with spelling, but her memory is good. All of her senses seem slightly off to her, especially her hearing and vision. Her balance is also slightly off. Sometimes, she has a tendency to fall slightly to the left while walking, or standing.
There are so many rubrics [symptoms] in the homeopathic repertory [the index of symptoms and their remedies] describing seizures; the sheer volume of rubrics has often troubled me. I would use half-a-dozen rubrics about the seizure in my repertorisation to come up with a remedy, but the seizures never seemed to get any better with these remedies.
During my training through the New England School of Homeopathy, one of Dr Paul Herscu’s — the renowned American homeopath — first lectures was on the indiviual versus the pathology. What does that mean? The thrust of the lecture was that in homeopathy we all know that we are treating the individual who has the illness, and not the illness itself.
What happens is that when the pathology gets severe, it is easy to forget that fact. If we are looking at seizures, multiple sclerosis [MS], amyotrophic lateral sclerosis [ALS], a motor neurone disease, cancer, or some other deeply disturbing physical problem, we lose our focus on the person and begin to focus on the pathology itself. Indeed, I used to do just that. I would choose all the rubrics about the seizures and completely forget that I was treating a person. I was deeply entrenched in my allopathic medical background.
Dr Herscu’s approach helped a lot. He suggested for all cases that one look for a remedy that seemed to fit the person, and then go back and see if the pathology would be covered by that remedy. I was doing the exact opposite. I was looking for a remedy to cover the seizures and then tried to fit that remedy to the person. It wasn’t totally illogical, but then again, it seldom worked.
Let’s look at this case and see.
Idea 1. In looking at Mary, the most prominent thing was that she was mentally slow, retarded, so I had to use that. I combined the rubrics: idiocy [I know it sounds extreme for this case, but the repertory was introduced before being politically correct was in vogue] with extremities, walk, slow learning to; and, mind, talk, slow learning to and made one rubric out of them to represent the idea of mental slowness. Dr Herscu emphasises the idea of combining rubrics, so that we do not lose remedy possibilities early on and so that the general idea of a particular problem is more completely represented.
Idea 2. The next big idea for me was the eruptions. This included the seizures. You can’t just focus on the seizures exclusively, yet you can’t forget about them either. I used another combined rubric: generalities, convulsions, menses, before; generalities, convulsions, menses, after; and, generalities, convulsions, menses, during. Even though she didn’t have many seizures during the menses there was a definite relationship between the seizures and the menses; so to be complete, I put them all in the combined rubric. I also included her tantrums in this idea of eruptions by including the rubrics: mind, anger, contradiction and mind, contradiction, intolerant of.
Idea 3. The next big idea for me was the romance novels. It seemed to be a big part of her life. She had book cases full of romance novels and although she claimed not to masturbate, there was certainly a romantic and sexual overtone to this major pastime. I combined the rubrics: mind, amorous disposition and mind, lascivious, for my third idea of pleasure.
Idea 4. My next thought was that she was rather sensitive. I tried to stay with the facts of the case and used the rather large rubric: mind, offended easily.
I then tried to put these four ideas in a cycle and verify it with the patient. She was slow mentally, which led to her not understanding and being more sensitive than usual. Later I realised that she would pull away into her own little world when her feelings got hurt. Her own little world consisted mostly of the romance novels. There everything was beautiful, glamorous, and perfect.
What pulled her out of this was her need to be with people, since she was so outgoing. Actually, she was trying to connect with someone, a special someone, if you will, by reading the romance novel. However, that ‘very try’ at connection was a solitary effort. It kept her more by herself and more alone. This led to eruptions; in this case, tantrums and seizures, which made her more confused and slow.
Using those four combined rubrics, about 25 homeopathic remedies came up. When I compared their cycles to the cycle that seemed represented by her life, as outlined in the above paragraph, the closest remedy which appeared was Bufo.
I could have used the rubric, mind, company, aversion to, solitude, fond of, and combined them with mind, company, aversion to, solitude, fond of, to practice masturbation to reflect the desire for solitude and then I could have used the rubrics: mind, company, desire for, to represent the desire to contact and communicate. But, I didn’t. I understood the full cycle later when I read Bufo. This fact is comforting to me as it reflects the fact that one does not need to understand the full cycle of a remedy to repertorise it correctly.
Dr Herscu’s methodology is extremely useful in trying to find the correct remedy in seizure cases when you remember to treat the individual and not the pathology. [For more general information about the use of cycles and segments in case taking, case analysis, repertorisation and the study of Materia Medica, read Stramonium with an Introduction to Analysis by Cycles and Segments by Dr Paul Herscu. NESH Press; 1996].
- Plan: Bufo rana 200C, one dose
- Follow-up, one month later
- The seizures have decreased quite a bit. There have been no tantrums. She feels more serene and her balance is better
- Plan: Wait
- Follow-up at ten months
Seizures much less frequent; less intense; occasional mild twitching of the face. Can go two or more months without any seizure activity - Plan: Wait. Decrease Tegretol to 200mg/day
- Follow-up at 15 months
- She is now more irritable and impatient
- More stubborn
- Fighting with sister
- Reads romance novels even more than before
- Running into things and dropping things
- Few more seizures this month.
- Mother died three months before
- Standing up for herself more, and telling people to do things for themselves when they ask her to do things for them that they should be doing for themselves
- More independent
- Plan: Repeat Bufo.
This patient has done extremely well for seizure control on Bufo.
This case illustrates a number of points.
- You have to understand the individual to find a remedy for the pathology
- Even a severe pathology, such as seizures, can respond to homeopathy
- The best way to understand the patient is to use the cycle of ideas
- You don’t need to have all the ideas in order to find the remedy; just the main ones
- Once you have a number of remedies to choose from your repertorisation, it is comparing the cycle of the remedy to the cycle of the patient that leads to the correct remedy.
