The Value of a Characteristic Symptom
by Joe Kellerstein ND
James first presented in Oct ’97. Being an octogenarian and nursing his ailing wife these last several years has been wearing. She suffered with a very aggressive Alzheimer’s and he was the principal caregiver. He gave the impression of having been a very cool guy in his time. The moustache was a neat short line not extending to the corners of the mouth. A full head of hair was carefully groomed, greased and combed straight back. James was quite lean and spoke with a kind of charm and humility that made me understand his immense success at selling cars. Caring for his wife was difficult. It was the constant vision of his beloved dwindling away that caused pain. There was sleeplessness, arrythmias and depression. Natrum mur was of great help through these crises. Ignatia and Natrum mur was of assistance in his grief afer the passing of his wife.
I had not consulted with James for about two years. It was February 2003. James and his very loving daughter paid a visit. It seems that since Oct 2002 he had just not felt well. Short term memory was declining rapidly. Tests confirmed this finding. He would forget what he was about to do. He would forget appointments. There was an awful fuzzy feeling in his head quite consistently now. The winter had been hard. He suffered flu and since then his health issues escalated. A previous complaint of his right foot easily falling asleep was somewhat improved. That is all I could get.
He seemed more withered than before. Age was advancing faster than time. I had no homeopathic case. There was the possibility of a nosode of the flu -a never well since, but I was not satisfied that the search for a symptomatic simillimum had been exhausted. So after some minutes of continuous questioning the description of the feeling ‘it is as if there was air in my head’ was given. I doubted the spontaneous remark and so challenged him on the description is several ways. It stood fast—air in the head it is. He was very comfortable that this turn of phrase perfectly conveyed what he felt in a clear and consistent way. So now to the search for the best match.
Because my questioning was careful and I felt without the bias of any underlying paradigm and because it was a physical sensation that could not be displaced from a feeling of comfortable accuracy I felt confident in its reliability as a guiding symptom. On consulting the repertory we find rubrics describing air rushing through the head or air filling the head. I double-checked this with the patient and he was not settled with this description. I did a search on the sensation in the repertory using my computer program. Most of the entries had indeed this feeling of air either filling with a kind of pressure implied or the moving sense of air rushing through. This was not satisfying. I began reading the full entries of each remedy. On coming to Benzoic acid in Allen’s Encyclopedia we find simply ‘sensation as if there were air in the head’. However, could this remedy especially known for its effect on the urinary tract and the urine that smells strong help in this kind of pathology? However, Benzoic acid also was noted to have the following symptom in Allen’s Encyclopedia: “ He was much surprised that, while writing, he omitted words every moment, which never was the case before (sixth and seventh day).” That totally satisfied me as to it’s possibility here.
Positive results were noted almost immediately. The sensation vanished and memory was much improved. I was thrilled.
This tiny case holds several useful teaching keys for me and some interesting points of contention;
1.James’ background as caregiver. This provides a possible etiology ‘ailments from nursing the sick’. Originally this rubric in Kent also referred to as ‘night watching’ has more recently been included in the more general rubric ‘Sleep,from loss of’in the General section of the repertory. But wait, was it the loss of sleep or the grinding down of his vitality seeing his beloved fade. Should we then use perhaps ‘ailments from grief’ or even more precisely the rubric, ailments from vexation (a chronic annoyance) with grief? Assuming I have taken a good case and been circumspect in subsequent questioning - the story does not structure itself so as to clarify a consistent point of emphasis to allow a differentiation here. The distance from these events to the onset of ill health without a clear linking sensation puts them in question as to being definitive etiology.
2.The definite decline in health with the flu ranks this a bit higher as a possible suspect for etiology but the time line could not be clarified with precision. Was the cognitive decline prior to the flu? It was tempting since clinically I have seen several cases of dementia seem to begin or accelerate after either after a flu shot or a severe bout of the illness per se. Where these cases did not have a clear genius or were non responsive to well selected remedies Influenzinum has been quite valuable. We might keep this as a desperation strategy well after the use of more clear cut patterns of characteristic symptoms.
3.What about the symptoms that describe James? He was clearly in love and very romantic. He was very dedicated. He was a cool guy and a good salesman. He was well groomed. I believe we do great harm to homeopathy by often erroneously emphasizing the story, themes and relatively normal psychological traits. These are not symptoms. George Dimitriadis of Australia reminds us that the term symptom is synonymous with disease complaint. Hahnemann tells us our concern is that which is ‘undoubtedly diseased’. And really - doesn’t that make life a lot more clear? Boenninghausen in his Lesser Writings tells us ‘not to be led astray by personal and individual traits,..’ ‘cases…too frequently look like some historical romance.’ This was going on even in his time and he objected. Aphorism 208 is pivotal. It clearly tells us why we have been sketching the patients general constitution character lifestyle habits, etc.(referring to aph 5) — it is to facilitate management and regime changes or needs for counselling—not primarily to determine the remedy—that is almost solely for the symptoms of the disease. Now the traits referred to can make a very secondary difference in remedy choice should further distinctions be needed and reliable guides to this information be available. Clinically I find that although these traits occasionally help it is much better to dig for treasure by using careful questioning of the disease symptoms.
4.In considering the disease symptoms we are after something that will narrow our choice. The more defined the symptom, i.e. by description or modality, the more valuable and reliable it promises to be. Even here we must be careful. Experience has shown that strange sensations related to physical symptoms are generally more reliable than those related to mental symptoms. Here, although it was related to a mental symptom the patient’s insistence on his description and its simplicity convinced me it was accurate. The reading of the remedy confirmed.
Joe Kellerstein ND, Studied with Andre Saine at the Canadian Academy of Homeopathy. He operates a post graduate program called “Homeopathy by the book”. He is President of the Association of Fellows of the Canadian Academy of Homeopathy and is dedicated to promoting educational excellence in the basics of Homeopathic practice and understanding. He practices in Toronto, Ontario, Canada.
