Quarterlyhomoeopathic Digest

QUARTERLYHOMOEOPATHIC DIGEST

Vol. IV No. 2 June 1987

CONTENTS

1. A CASE OF DIABETIC PERIPHERAL NEUROPATHY TREATED WITH ZINCUM MET.IN LOW POTENC
2. THE EFFECT OF FREQUENT REPETITIONS OF HIGH

POTENCY PLATINA IN AN ADOLESCENT BEHAVIORAL

PROBLE

1. TAKING A HISTORY
2. HOMOEOPATHY IN ALLERGIC DISEASES
3. ARSENICUM ALBUM IN LICHEN RUBER PLANUS
4. AN INTERESTING CASE OF ANGINA PECTORIS
5. ROUTINE TREATMENT OF MEASLES?
6. ROUTINE TREATMENT OF SCARLATINA?

A CASE OF DIABETIC PERIPHERAL NEUROPATHY TREATED WITH ZINCUM MET. IN LOW POTENCY

R.A.K. JACK

Mrs. M.G., age 44, first consulted me on 20.8.82 and gave the following history. She had suffered from diabetes since 6 years old and had insulin twice daily for the last 37 years, including 32 years on protamine zinc insulin. All this time she had been under regular hospital surveillance, and was currently maintained on on insulated (pork isophane insulin) 40 strength, 9 units b.d. Her diabetes was still unstable, she could not control her glycosuria satisfactorily, and still had severe attacks on hypoglycaemia. (she failed to keep one of her subsequent follow-up appointments because on that morning her husband found her nearly unconscious, and just managed to get sugar into her before the ambulance arrived inresponce to his 999 call.) Ten years ago she had developed severe diabetic peripheral neuropathy, and in recent years had a frozen shoulder (left), a transposition of her left ulnar nerve (1981), and an operation for a left median carpel tunnel syndrome (1981). To add to her problems she suffers from angina pectoris and fluid retention.

For the previous year her medication had been :

Dolobid (diflunisal) qid.

Feldene (piroxicam 10 mg) tid.

Distalgestic (dextropropoxyphene) 8 tabs daily

Sectral (acebutolol) 100 mg daily

Frusemide 40 mg on alternate mornings, alternating

With Moduretic (amiloride and hydrochlorothiazide).

Despite this heavy dosage with analgesics she was still in considerable pain.

She complained of :-

1. severe pain “like someone permanently sticking needles in the soles of my feet’s and “like electric shocks in my legs and bottom”, especially severe at night, and on waking. The pain was better by cold, so that she spent most evenings sitting on rubber ring with her legs exposed.
2. Severe cramping pains on sitting, necessitating constant changing of position. She had to stop the car three times during the 20 miles journey to her consultation, and be helped out, to stretch her legs, to ease her pain. These pains began about 10 years ago, but had been very much worse for the last year.
3. Loss of sensation in her legs, and loss of balance after sitting so that she had “to be helped to get balanced on attempting to stand up and walk”. She was only able to walk about 20 yards.
4. Total bilateral anaesthesia of lower limbs, up to her thighs. (she demonstrated how she could insert a hypodermic needle full length into different parts of her thigh without any feeling of pain).
5. Inability to dorsiflex her ankles, so that in the days when she was still able to drive, she had to lift the whole of her foot off the pedal.
6. Inability to stand unless wearing shoes with adequate high heels.
7. Paraesthesia of upper limbs. “My arms go numb, so I don’t know where they are”. “It makes me drop my knitting”. Wrists and fingers stiff and numb on waking, with “jumping pains” better by movement.
8. Dependency on others, needing help to get up in the morning and and dress. “ I have to come down stairs on my bottom”. “All joints from the waistdown are painful and stiff on waking”, necessitating movement to ease.
9. Profound lassitude.
10. Ulcers of her ankles and feet, and recurrent sepsis around her toe nails. The ulcers started about 5 years ago, invariably following minor trauma, lasted 6-8 weeks, and there was usually at least one present at a time.
11. Fluid retention. “If I don’t take my diuretics I rapidly gain 2 stone (12.7 kg) in weight.

Treatment : As her most pressing need was for relief of pain, I prescribed mainly on her particular symptoms :

1. Phytolacca 3rd qid until improvement.

2. If no response after 10 days change to Agaricus 3rd qid.

I instructed her to continue taking all her conventional medication, explaining that in her case homoeopathic medication was an additional therapy, but that she could reduce the analgestics if she found the pain diminishing.

Phytolacca in its provings produces:

Shooting pains like electric shocks, that radiate,

Especially in the distribution of the brachial plexus,

And sciastic distribution.

Rheumatic type of pains—very like those produced by Rhus tox., i.e.,

Worse a.m.worse wet worse cold worse night

Better warmth better dry but are worse motion (like Bryonia)

In the united states of America the fruit and root of the plant have been used to relay pain, and as an antirheumatic.

Agaricus (which contains muscarin) in contrast produces :

Jerkings, twitchings, trembling, chorealike movements, and itching.

Neuralgia—painful spasms, tearing pains, with numbness,

Coldness and tingling worse cold better movement

Paralysis of lower limbs

Pains as if pierced by needles of ice

Itching of toes, and feet, as if forozen—burning,

Itching, redness

Swelling as if from frost bite (hence its use homoeopathically in the treatment of chilblains)

Ataxia

At her second visit 2 months laer (22.10.82) she reported :

Slepping better

Discontinued all dolobid and feldene, and reduced distalgesic from 8 to 2 daily.

“I have only taken 4 in last 4 days”.

She considered Agaricus helped more than phytolacca,

And after 3 weeks has reduced the dose to Agaricus 3rd

One nocte only. “It stops me waking yp”.

She could not sit for short spells without her cushion

Rx Zinc, - met, 200 * 1, repeating every 14 days if required.

22.12.82“Zinc. Helped for 3-4 days , but best, improvement came after reverting to Agaricus”.

“Occasionally wakened by restless legs, then I have to walk the room”.

Rx Zinc. Met, 10M *1 and try Zinc. Met. 6 tid in place of Agaricus.

19.1.83“Zinc. 6 suits better than Agaricus 3rd.”

She c/o burning, swollen, hot, stinging wrists, swollen feet and ½ stones (3.2.Kg) weight gain each evening (despite diuretics) which disappeared each morning.

Rx Apis 3rd qid until relief.

2.3.82Discontinued all conventional analgesics for last 3 weeks. Apis relieved both wrist pains and fluid retention dramatically.

“I can now move easily, and walk 50 yards, the best for over ayear.”

“I have no jumping pains, and the numbness is considerably improved.”

9.5.83No analgesics for last 3 months.

Sleeping more comfortably—less dependent, more mobile. Takes Zinc. 6.q.h. 1- doses on days when returns, on average on four days each fortnight. She stated that one or two doses of Zinc.6 predictably stopped her pain. However, she complained of persistent dyspepsia for last month with hunger pains, eased by Tagament(cimetidine) and Maxolon (metoclopramide).

She was awaiting a cholecystogram.

she was intolerant of fats, admitted to being “wet eyed” (found her eyes watered when saw, or heard anything moving or touching); she liked change. (“My husband is often surprised when he comes home, because I’have had the furniture rearranged.”)

Rx Pulsatilla 30qh until reaction.

14.5.83Five days later she attended the Midlands Branch Tutorial at SellyOasisHospital as a case demonstration.

she started her dyspepsia was already much improved, “better than in all the previous month”.

In the discussion that followed, Dr. Mollie Hunton observed that there was a relationship between plasma Zinc levels and healing of ulcers, and asked if the patient’s ulcers has improved since using Zinc.6. On learning that there had been no significant change, she suggested giving dietary zinc. Dr. Anita Davies, who made a video recording of the demonstration, commented on the balance between zinc and copper in the body, and that the body used up a lot of zinc in healing ulcers. She suggested that a plasma Zinc estimation might be of value.

12.9.83Patient is still controlling her neuralgia adequately with zinc. met. 6. “These pain goes within one hour of taking a tablet.” Her cholecystogram and gastric investigation were all unremarkable.

11.10.83Not taken any conventional analgesics for the last 8 months.

Pulsatilla no longer eased her dyspepsia, but surprisingly she found that Zinc mets.6 did, and was more effective than Maxolon. She needed to take it qid, otherwise her gastralgis lasted for hours. Her neuritic pains were still control effectively with Zinc. She could now walk3/4 of a mile—a big improvement on her original limits of 20 yards.

Discussion

McLeod states that “the most common form of peripheral neuropathy in diabetes llitus is a symmetrical, predominantly sensory, polyneuropathy. When there is severe sensory impairment, perforating ulcers of the feet and neuropathic joints may occur, both associated sensory ataxia (diabetic pseudo-tabes). Motor and sensory conduction are impaired.

“Isolated peripheral nerve lesions are common, particularly carpel tunnel syndrome, nar nerve lesions at the elbow are radial, feromal and lateral popliteal nerve lsies.”

The same author lists the metals and industrial agents that cause peripheral neuropathy, and includes arsenic, lead, mercury, thallium and gold (but not zinc)

The reason I considered Zinc. met. might be even more effective than Agaricus was cause of two previous occasions when I had prescribed it for diabetic patients with peripheral neuropathy. Both had received protamine zinc insulin (PZI) for many years, and both found that low potency Zinc. met. afforded considerable relief. This patient had PZI for 32 years, and displayed several of the features one associations with the provings of Zincum :

Severe pain, twitching and trembling of her lower limbs with marked weakness.

Pain temporarily relieved by motion, making her constantly move her legs and change position (“restless legs”, “fidgety feet”).

Very sensitive soles of her feet.

Profound prostration,”feeling totally exhausted”, with mental apathy.

Dyspepsia.

She claims that Zinc . affords more relief than Agaricus, which certainly helped her.

Summary

This woman was presented at our Tutorial, for teaching purpose only, and not in an attempt to prove that Zinc. met. in potency would predictably alleviate, or improve diabetic neuropathy. It is interesting to speculate on the possible association between her prolonged use of PZI and the apparent benefit she obtains from low potency Zinc.

It is also worth observing that it often happens, as in this case, that more than the drug in low potency may help a patient, though none may be the exact similimum; previously the one whose side effects most effective. Finally, this patient found more benefit from low potency Zinc. than high—confirming common experience that where there the advanced pathological change, with physical rather than mental symptoms, low potency describing is generally the most successful.

[From THE BRITISH HOMOEOPATHIC JOURNAL, Vol.73, No.1 January 1984; for private circulation only)

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THE EFFECT OF FREQUENT REPETITIONS OF HIGH POTENCY PLATINA IN AN ADOLESCENT BEHAVIORAL PROBLEM

William Shevin, M.D., D.Ht.

(The following paper was presented to the December 12, 1985 meeting of the Connecticut state Homoeopathic Medical Society. Participants were, in addition to Dr. Shevin, T.C. Cherian, M.D., Ahmed Currim, M.D., William F.McCoy, M.D., and PercyRyberg, M.D.)

INRODUCTION : This paper is a report on R.M. who was born on January 12,1968 and who first consulted me with his mother on August 8, 1984. His chief complaints were : 1) “confuse” feeling since the fall of 1983, 2) constant fatigue, 3) recurrent low fevers sometimes accompanied by streptococcal infections mostly in the winter, and 4) headaches.

In childhood, he had chickenbox, but was otherwise healthy. Somewhere around 1982, he rebelled against his father demanded good marks. The patient had always wanted to go to military school, and believed his father would support him financially. There was great disappointment when his father refused to do so. He became furious, but did not direct his danger towards the father. In September 1982, he developed fatigue and sore throat. The diagnosis of a streptococcal throat was made and was treated with antibiotics. In November 1982, he developed dizziness which he described as a sudden “spinning, black hole”. There was no loss of consciousness. He also had nausea and blood in urine although not much detail is known about these last symptoms. As of January 1983, he continued to be fatigued. Mononucleosis was diagnosed. No treatment was offered. By August 1983, a confusional state became more prominent, which I shall presently described.

Somewhere in late 1982 or early 1983, he began to crave sweets intensely. He would hide abox of cookies in his room and consume them all at once. After the intake of sugars, he became increasingly fatigued and would sleep for up to 16 hours; he would experience a “confused” state of mind.

“Confusion” means, in this case, “strange thoughts.” “For example, while walking down the street he imagined that a telephone pole would leave the sidewalk and obstruct is path, or that he would be run over by a car even though there was no car in sight. There was no anxiety with these thoughts. Following such thoughts would come a state of feeling very powerful, very strong.” A good feeling, like I could do anything Iwanted do.” “Very much in control.” Sometimes he would go out in the woods with friends and shoot animals. Once they physically abused a schoolmate, but generally the violence took the form of killing animals. This state would last for approximately 24 hours, and there was no remorse following it.

He became “addicted” to classical music, listening to “stormy” music (Wagner) for hours on end. He tended to separate from his friends. He didn’t like people and feel that the music was only thing that mattered. He felt that other people were “beneath” him and sank into a rather depressed, fatigued state. He felt much, much better if he lifted weights vigorously, or during thunderstorms. He read a lost of historical novels focusing on Hitler, extreme violence, bloodshecd, etc. He developed fantasies of killing which by the end of 1983, he was acting out as described above.

In December 1983, his mother diagnosed hypoglycemia and instituted rigid control of his diet. This resulted in great improvement of his symptoms. The depressive state with great interest in violent music, subsided. He became less violent, but was still fascinated by Hitler memorabilia and had a pedestrian might step out in front of them, he delighted in describing , in gory detail, the consequences of them hitting the person. If he did eat an appreciable amount of sweets, he would become confused, developing feeling of “power”, as described above.

FAMILY HISTORY

Many relatives on the father’s side had allergies (pollens, grasses, etc.). His mother had eczema as a child. One grandfather had amyotrophic lateral sclerosis.

Hunger made him “weak” and produced a feeling of “don’t give a damn,” plus defiance. Other than the symptoms described above, there was very little else. He appeared somewhat bored during the interview and clearly felt that he was just talking to humor his mother. He didn’t feel he had any problems even though he was willing to describe his feelings freely to me. To the question: “How do you cope with stress and conflict?” he answered, “I meet it head on and destroy,” or “I fade out go into a world where I win.” Despite his symptoms, he really felt that he was in great health. He appeared very muscular, calm, slightly aloof. His goal was to be a jet fighter pilot in the Air Force. Physical examination was unremarkable.

I was struck by the air of superiority of this child. He felt that everyone else in his grade was “stupid” and that he was biding his until he could get into the Air Force. He felt all-powerful. This lead me to consider platina. Hering’s guiding symptoms lists the following.

- Attacks of cheerfulness; feeling of strength.

- Great indifference.

- Arrogant, reserved, absent-minded.

- Pride and overestimation of one’s self; looking down with haughtiness on others.

- Very peevish and easily excited; he could have beaten anyone without provocation.

- Everything seems strange and horrible to him.

- Sits alone, sad and morose, without talking.

- Illusions of fantasy on entering the house after walking an hour.

- Talks almost continually about fanciful things or such as having really occurred.

- Mental disturbance after fright, grief, or vexation.

Hering makes no mention of complaints following hunger, craving for sweets, aggravation from sweets, atc. Platina also tends to have many symptoms of anxiety which were completely absent from this case. The lack of moral feeling was prominent. I also considered Anacardium, sepia, and Lycopodium. On August 14, 1984, I gave one dose of platina 30c and asked the mother to call back in three days.

When she called, she said that she had noticed a “drastic” change in her son. For 24 hours following the dose of Platina, “I had my old son back”, He became considerate. More open, etc. She noted that on a car trip, he was concerned about some pedstrains, warning her to watch out for them. I ordered platina 30C once daily.