An Overview of Lyme Disease and its Connection to the Ericaceae Family
By Harry van der Zee – Homeopathic Links (Information compiled by Anton Kramer and taken from various sources)
Introduction
Remedies from the Ericaceae family that are known in homeopathy are: Chim-m, chim, epig, kalm, led, rhod, uva, gaul, oxyd, arbu, manz, vacc-m, chim-rot, arbin, heath-B, callun, andr-g, chamd-c, gaul-h, gay-b, vacc-c, vacc-o, arb-m. Ledum, Kalmia and Rhododendron are the best known. Typical is the lack of a known mental picture.
Botanical
The plants in this family grow often on poor soil. The heathers are known for their growth in sandy fields.
They contain big quantities of silicates and that's why they were used as brooms in the past.
Psychological
In general these people are not very marked. They avoid to stand in the center of attention and feel better doing their job in a quiet and practical way. But they long for recognition and compliment. But they don't get them easily, due to the fact that they work in silence and away from the public. In the end they can become bitter about it. An expression of them could be: "I try to do my best, I take little for myself, I give so much, I'm not arrogant, I'm quiet and earnest, work hard and good, overexert myself, try to be good to everyone in my own quiet way and still it's not good enough, I don't succeed, I'm not loved or respected."
Work
They work hard and try to do their job as perfect as possible.
After many years they can develop an aversion to work further, especially when they feel that no one appreciates their work.
Work aversion
Dull
Restless
Fear failure, falling
Sensitive
They are very sensitive people, sensitive to the needs of others. But also sensitive to noises:
Oversensitive < noise, < pain; general, shame.
Soft, Mild
In general they are soft, mild. They are not very aggressive.
Mild, yielding
Serious
Company
Family is very important for them. They often do their jobs for the family. Mothers can do a lot for their children.
But they are not very communicative, not very open. Practical and reserved.
Aversion company, friends; <- answering, slow answering
Sexual
Amorous dreams + pollutions. Fear man
Anxious
Dreams frightful, murder, troublesome
Body and thoughts are separated
Delusion
Despised, failure, exposed to rain, poisoned, mocked
Mental
Dull, concentration difficult, forgetful, confusion, memory weak, thoughts vanishing
Stupefaction, coma, delirium
Mood
Sad, morose, sulky, tearful, weepy, displeased, capricious
Physical
Lyme disease is a typical expression for this family. (see the chapters below)
Headache < motion, touch;
bones, skull, vertex, forehead, eyes above, occiput, sides, temples, brain
pressing, tearing, hot, heavy, loose
Eyes inflammation, itching, burning, pain
Vision; COLORS before the eyes, weak.
Nose coryza, obstruction, sneezing
Mouth: pain, dry, burning, salivation,
Taste: bitter. Teeth weak, crumbling
Larynx & trachea: tickling, scraping, hoarse.
Respiration: asthmatic.
Heart: pain, palpitation.
Stomach; nausea, vomiting, pain, retching, eructation
Abdomen: pain, rumbling, noises, distension, liver pain.
Rectum: constipation, diarrhea
Bladder: cystitis, urethritis, gonorrhoea, nefritis, ureteritis,
pain, neck, < urge
Urging (3), dribbling
Urination frequent, less, burning pain urethra.
Prostatitis, prostate enlarged
Testis pain, penis itching,
Urine: albuminous, bloody, green, pale, red, yellow, profuse, scanty, sediment, calculi, sand.
Uric acid diathesis, stones.
Vaginitis, leucorrhea.
Menses: frequent, too early, too soon, profuse, painful, dysmenorrhea
Extremities pain, fibromyalgia, stiff, gouty, muscle, joint, bone
All places: sides, ribs, axilla, sternum, chest, mammae, upper limbs, shoulders, upper arms, elbows, forearms, wrists, hands, fingers, fifth, little, sciatic, hips, thighs, knees, hollow of, legs, tibia, calves, ankles, feet, toes, first
Aching, drawing, gouty; joints, pressing, rheumatic; sprained, stitching, tearing, wandering, heavy, tired
Paralytic, wandering
Backache: spine, cervical, dorsal, between scapulae, lumbar aching, pressing, rheumatic, tearing, stiff.
Dermatitis: red, itching, eczema, herpes, vesicles, crawling, ulcers.
Generals
Weather: chilly, < open air, < cold, < wet, < uncovering.
Food: -> drinks, thirsty, -> alcohol.
Physical: < motion, < exertion, < ascending, turning, over lifting, straining of muscles and tendons. > rest
Localization: left, crosswise.
Abscess, cancer, ulcer, dropsy, faint
DD
Iron series: hard working, perfectionism.
Silicium: family oriented.
Lyme Disease:
The initial infection with Borrelia burgdorferi is characterized by a local skin eruption that grows circumferentially with central clearing, suggestively termed a target rash. Borrelia can be isolated from this eruption, but is apparently disseminated systemically from the moment of initial infection.
Secondary disease expression is highly individually variable, and Lyme disease is known as a great imposter for its ability to mimic many disease conditions. The most common presentations involve inflammation of the large joints and peripheral nerves. Neurologic and cardiac complications may follow.
The Group Anamnesis
If we collect the common symptoms of Lyme disease from reports in the conventional medical literature, we can begin to construct a group anamnesis of the disease, in order to identify the most likely remedies for the disease genus.
The classical target-rash of Lyme disease is not described in our homeopathic literature. The closest description we can find is:
SKIN - ERYSIPELAS
- which can reasonably be expected to include remedies capable of covering the erysipelas-like Lyme target rash.
A common early post-rash symptom of Lyme disease is sore throat:
THROAT - PAIN - sore
The Arthralgias
The arthralgias of Lyme most commonly begin with rheumatic pain in the neck, with associated headache:
BACK - PAIN - Cervical region
BACK - PAIN - Cervical region - rheumatic
HEAD - PAIN - rheumatic
Lyme classically presents with a combination of inflammatory arthralgic pains and inflammatory neuralgic complaints:
GENERALS - INFLAMMATION - Joints; of
EXTREMITIES - PAIN - rheumatic
GENERALS - INFLAMMATION - Nerves; of
GENERALS - PAIN - neuralgic
The arthralgias focus in the shoulders, hips and knees, and may be of acute and/or chronic nature:
EXTREMITIES - INFLAMMATION - Joints
EXTREMITIES - PAIN - Joints - rheumatic
EXTREMITIES - PAIN - Shoulder - rheumatic
EXTREMITIES - PAIN - Hip - rheumatic
EXTREMITIES - PAIN - Knee - rheumatic
EXTREMITIES - PAIN - rheumatic - acute
EXTREMITIES - PAIN - rheumatic - chronic
The Neuralgias
The neuralgias are most typically facial or sciatic:
FACE - PAIN - neuralgic
EXTREMITIES - PAIN - Lower limbs - sciatica
There is a characterizing uniqueness in the concomitance of heart symptoms with the arthralgias and neuralgias, with the potential for inflammatory rheumatic myocarditis and/or pericarditis:
EXTREMITIES - PAIN - Joints - alternating with - Heart symptoms
CHEST - HEART; complaints of the - rheumatism, after
CHEST - PAIN - Heart - rheumatic
CHEST - INFLAMMATION - Heart
CHEST - INFLAMMATION - Heart - Endocardium
CHEST - INFLAMMATION - Heart - Pericardium
An important aspect of the "pace" of Lyme disease, is the migratory nature of its arthralgias/neuralgias, and the rapid change and alternation of symptoms:
GENERALS - PAIN - wandering
GENERALS - CHANGE - symptoms; change of - rapid
We can take these common symptoms of Lyme disease, obtained from the population affected and treated as if one person; and repertorize this list, to find:
Kalmia and Ledum lead the analysis. Intriguingly, Kalmia latifolia (Mountain Laurel) and Ledum palustre (Labrador Tea) are closely botanically related, both belonging to the botanical family Ericaceae; the Heath family.
Small Remedies
A small-remedies weighting brings up several remedies poorly represented in our literature. Notably, Rhododendron chrysanthum - another Ericaceae - moves up to 4th position.
The algorithms used in the Vithoulkas Expert System bring out Ledum as the remedy bearing closest similitude to this group anamnesis. Kalmia and Rhododendron make good showings in this analysis as well. Leading the list of "very small remedies" here is Gaultheria procumbens (wintergreen, teaberry) - a fourth member of the Ericaceae family.
Whereas Ledum may have a slow and long-continued pace (reflected in its presence in PERSPIRATION - LONG-LASTING), these remedies as a group - including Ledum - are characterized by periodic and alternating symptoms. This actually is a rather interesting aspect of the general similitude of this group of remedies to the characteristic pace, or development over time, of Lyme disease.
These studies could productively be extended to the investigation of the neurologic and cardiac symptoms of the Ericaceae, in the context of the importance of these pathologies in Lyme disease.
The Missing Pieces
I am particularly fascinated by the missing pieces of the Lyme disease - the Ericaceae connection. What might an adequate proving of Gautheria procumbens bring out? Will the Ericaceae’s unknown to our art and science fill in the obvious pathogenetic gaps between the known members of this family?
A Brief History of Lyme Disease
Introduction: Lyme disease was named in 1977 when arthritis was observed in a cluster of children in and around Lyme, Connecticut. Other clinical symptoms and environmental conditions suggested that this was an infectious disease probably transmitted by an arthropod. Further investigation revealed that Lyme disease is caused by the bacterium, Borrelia burgdorferi. These bacteria are are helical shaped bacteria about 10-25 m long. They are transmitted to humans by the bite of infected deer ticks and cause more than 16,000 infections in the United States each year. (This figure is out of date and given the complexity of chronic lyme disease today, the figure is more likely in the hundreds of thousands – Ed).
Vector: Black-legged ticks (Ixodes scapularis) are responsible for transmitting Lyme disease bacteria to humans in the northeastern and north-central United States. On the Pacific Coast, the bacteria are transmitted to humans by the western black-legged tick (Ixodes pacificus). Ixodes ticks are much smaller than common dog and cattle ticks. In their larval and nymphal stages, they are no bigger than a pinhead. Ticks feed by inserting their mouths into the skin of a host and slowly take in blood. Ixodes ticks are most likely to transmit infection after feeding for two or more days.
Risk: In the United States, Lyme disease is mostly localized to states in the northeastern, mid-Atlantic, and upper north-central regions, and to several counties in northwestern California. In 1999, 16,273 cases of Lyme disease were reported to the Centers for Disease Control and Prevention (CDC). Ninety-two percent of these were from the states of Connecticut, Rhode Island, New York, Pennsylvania, Delaware, New Jersey, Maryland, Massachusetts, and Wisconsin.
Individuals who live or work in residential areas surrounded by tick-infested woods or overgrown brush are at risk of getting Lyme disease. Persons who work or play in their yard, participate in recreational activities away from home such as hiking, camping, fishing and hunting, or engage in outdoor occupations, such as landscaping, brush clearing, forestry, and wildlife and parks management in endemic areas may also be at risk of getting Lyme disease.
Prevention and Treatment: It is important to remember that prevention measures can be effective in reducing your exposure to infected ticks, and most patients can be successfully treated with antibiotic therapy when diagnosed in the early stages of Lyme disease. Visit the links below for more information on the following topics:
History of Lyme Disease: Early in the 20th century, European physicians observed patients with a red, slowly expanding rash (called erythema migrans or EM), associated this rash with the bite of ticks, and postulated that it was caused by a tick-borne bacterium. Then in the 1940s, similar tick-borne illness was described that often began with EM and developed into multi-system illness. Later that decade, spirochete-like structures were observed in skin specimens leading to the use of penicillin for treatment.
Aware of these findings, a physician in Wisconsin diagnosed a patient with EM and successfully treated it with penicillin in 1969. In the mid-1970s, physicians observed clusters of children with arthritis in and around Lyme, Connecticut. Other clinical symptoms and environmental conditions suggested that this was a distinct illness probably transmitted by an arthropod. Researchers linked the presence of EM rash lesions to preceding tick bites and determined that early treatment with penicillin not only shortened the duration of EM but also reduced the risk of subsequent arthritis.
In 1982, spirochetes were identified in the mid-gut of the adult deer tick, Ixodes dammini (referred herein by its original name, the black-legged tick, Ixodes scapularis) and given the name Borrelia burgdorferi. Finally, conclusive evidence that B. burgdorferi caused Lyme disease came in 1984 when spirochetes were cultured from the blood of patients with EM, from the rash lesion itself, and from the cerebrospinal fluid of a patient with meningoencephalitis and history of prior EM.
The Centers for Disease Control (CDC) began surveillance for Lyme disease in 1982 and the Council of State and Territorial Epidemiologists (CSTE) designated Lyme disease as a nationally notifiable disease in January 1991.
Symptoms
Lyme disease most often presents with a characteristic "bull's-eye" rash, erythema migrans, accompanied by nonspecific symptoms such as fever, malaise, fatigue, headache, muscle aches (myalgia), and joint aches (arthralgia). The incubation period from infection to onset of erythema migrans is typically 7 to 14 days but may be as short as 3 days and as long as 30 days. Some infected individuals have no recognized illness (asymptomatic infection determined by serological testing), or manifest only non-specific symptoms such as fever, headache, fatigue, and myalgia. Lyme disease spirochetes disseminate from the site of the tick bite by cutaneous, lymphatic and blood borne routes. The signs of early disseminated infection usually occur days to weeks after the appearance of a solitary erythema migrans lesion. In addition to multiple (secondary) erythema migrans lesions, early disseminated infection may be manifest as disease of the nervous system, the musculoskeletal system, or the heart. Early neurologic manifestations include lymphocytic meningitis, cranial neuropathy (especially facial nerve palsy), and radiculoneuritis. Musculoskeletal manifestations may include migratory joint and muscle pains with or without objective signs of joint swelling. Cardiac manifestations are rare but may include myocarditis and transient atrioventricular blocks of varying degree. B. burgdorferi infection in the untreated or inadequately treated patient may progress to late disseminated disease weeks to months after infection. The most common objective manifestation of late disseminated Lyme disease is intermittent swelling and pain of one or a few joints, usually large, weight-bearing joints such as the knee. Some patients develop chronic axonal polyneuropathy, or encephalopathy, the latter usually manifested by cognitive disorders, sleep disturbance, fatigue, and personality changes. Infrequently, Lyme disease morbidity may be severe, chronic, and disabling. An ill-defined post-Lyme disease syndrome occurs in some persons following treatment for Lyme disease. Lyme disease is rarely, if ever, fatal.
Diagnosis
The diagnosis of Lyme disease is based primarily on clinical findings, and it is often appropriate to treat patients with early disease solely on the basis of objective signs and a known exposure. Serologic testing may, however, provide valuable supportive diagnostic information in patients with endemic exposure and objective clinical findings that suggest later stage disseminated Lyme disease. When serologic testing is indicated, CDC recommends testing initially with a sensitive first test, either an enzyme-linked immunosorbent assay (ELISA) or an indirect fluorescent antibody (IFA) test, followed by testing with the more specific Western immunoblot (WB) test to corroborate equivocal or positive results obtained with the first test. Although antibiotic treatment in early localized disease may blunt or abrogate the antibody response, patients with early disseminated or late-stage disease usually have strong serological reactivity and demonstrate expanded WB immunoglobulin G (IgG) banding patterns to diagnostic B. burgdorferi antigens. Antibodies often persist for months or years following successfully treated or untreated infection. Thus, seroreactivity alone cannot be used as a marker of active disease. Neither positive serologic test results nor a history of previous Lyme disease assures that an individual has protective immunity. Repeated infection with B. burgdorferi has been documented. B. burgdorferi can be cultured from 80% or more of biopsy specimens taken from early erythema migrans lesions.
However, the diagnostic usefulness of this procedure is limited because of the need for a special bacteriologic medium (modified Barbour-Stoenner-Kelly medium) and protracted observation of cultures. Polymerase chain reaction (PCR) has been used to amplify genomic DNA of B. burgdorferi in skin, blood, cerobro-spinal fluid, and synovial fluid, but PCR has not been standardized for routine diagnosis of Lyme disease.
Other Tick-Borne Diseases
Southern Tick-Associated Rash Illness
Babesiosis
Ehrlichiosis
Rocky Mountain Spotted Fever
Cultivation
The spirochete isolated from ticks and humans was described as Borrelia burgdorferi by Johnson, et al. in 1984. B. burgdorferi can be cultivated from their arthropod vectors or vertebrate hosts in a modified Kelly medium called BSK (Barbour-Stoenner-Kelly). Borrelia from ticks and from the blood, skin, and cerebrospinal fluid of Lyme disease patients have been successfully cultivated in BSK. BSK solidified with 1.3% agarose allows the production of colonies from single organisms. B. burgdorferi grows slowly as compared to most bacteria. Each spirochete divides into two cells after 12 to 24 hours of elongation. Although the organism can be cultured in media, continuous passage may result in biological changes resulting in a population quite different from their naturally occurring ancestors.
Human disease
The type of Borrelia infecting humans in the U.S. is designated B. burgdorferi sensu stricto. B. burgdorferi sensu strico and two related Borrelia, B. garinii and B. afzelii also cause Lyme disease in Europe. In Asia, only B. garinii and B. afzelii cause Lyme disease in humans. Evidence is accumulating that these closely related, but different, spirochetes are associated with somewhat different disease expressions. Arthritis appears to occur more frequently following infection with B. burgdorferi sensu stricto; neurologic manifestations are more common in infections with B. garinii; and cutaneous manifestations occur more frequently in association with B. afzelii infection.
Structure
Borrelia, including B. burgdorferi, are flexible helical cells comprised of a protoplasmic cylinder surrounded by a cell membrane, 7 to 11 periplasmic flagella, and an outer membrane that is loosely associated with the underlying structures. The DNA sequence of B. burgdorferi type strain B31 was published in 1997 and contains a 950 kilobase linear chromosome, 9 linear plasmids, and 12 circular plasmids. The outer membrane of B. burgdorferi and other Borrelia is unique in that genes encoding its proteins are located on linear plasmids; these extrachromasomal genes determine the antigenic identity of these organisms and presumably help the bacteria adapt and survive in ticks and different mammalian hosts.
Vector Ecology
Lyme disease is spread by the bite of ticks of the genus Ixodes that are infected with Borrelia burgdorferi. For Lyme disease to exist in an area, at least three closely interrelated elements must be present in nature: (1) the Lyme disease bacteria B. burgdorferi (2) Ixodes ticks that can transmit the bacteria, and (3) mammals such as mice and deer to provide a blood meal for the ticks through their various life stages.
Tick Habitat
In the United States, ticks of the genus Ixodes serve as the competent vectors for transmitting the Lyme disease bacteria, B. burgdorferi to humans. Ixodes ticks can be found in temperate regions with high relative humidity at ground level. Known as the deer tick or black-legged tick, Ixodes scapularis is responsible for transmitting bacteria to humans in the northeastern and north-central United States. In eastern states, ticks are associated with deciduous forest and habitat containing leaf litter. Leaf litter provides a moist cover from wind, snow, and other elements. Importantly, research demonstrates that tick populations are reduced 72-100% when leaf litter is removed. In the north-central states, I. scapularis is generally found in heavily wooded areas often surrounded by broad tracts of land cleared for agriculture. On the Pacific Coast, the bacteria are transmitted to humans by the western black-legged tick (Ixodes pacificus) and habitats are more diverse. Here, ticks have been collected in habitats with forest, north coastal scrub, high brush, and open grasslands. Coastal tick populations thrive in areas of high rainfall, but ticks are also found at inland locations.
Life cycle of the deer tick
Knowing the complex life cycle of Ixodes ticks is important in understanding the risk of acquiring Lyme disease and in finding ways to reduce this risk. For this example, we will describe the two year life cycle of an I. scapularis deer tick located in a northeastern state. Life cycles may vary slightly for other ticks located in different regions of North America.
The life cycle requires 2 years to complete. Adult female ticks lay eggs on the ground in early spring. By summer, eggs hatch into larvae. Larvae feed on mice, other small mammals, deer, and birds in the late summer and early fall, molt into nymphs, and then are dormant (inactive) until the next spring. Nymphs feed on rodents, small mammals, birds and humans in the late spring and summer and molt into adults in the fall. In the fall and early spring, adult ticks feed and mate on large mammals (especially deer) and bite humans. The adult female ticks then drop off these animals and lay eggs in spring, completing a 2-year life cycle.
Natural reservoirs
Ticks, small rodents, and other non-human vertebrate animals all serve as natural reservoirs for B. burgdorferi. This means that the Lyme disease bacteria can live and grow within these hosts without causing them to die. Larvae and nymph ticks typically become infected with the Lyme disease spirochete, B. burgdorferi, when they feed on small animals that carry the bacteria in spring and summer. The bacteria remain in a tick as it changes from larva to nymph or from nymph to adult in late summer or early fall. Infected nymphs bite and transmit B. burgdorferi bacteria to other small rodents, mammals, and humans, all in the course of their normal feeding behavior.
Transmission to Humans
Research in the eastern United States has indicated that, for the most part, nymphal ticks transmit Lyme disease bacteria to humans from May to July. Feeding nymphs are rarely noticed because of their small size, and thus have ample time to feed on humans. Tick-to-human transmission of the Lyme disease bacteria usually occurs after approximately 2 or more days of feeding. Although tick larvae are smaller than nymphs, they rarely, if ever, carry B. burgdorferi at the time of feeding and are not important in the transmission of Lyme disease to humans.
Adult ticks can transmit the disease, but since they are larger and more likely to be removed from a person's body within a few hours, they are less likely than nymphs to have sufficient time to transmit the infection. As expected, few cases of Lyme disease are reported in the cooler months of the year, when adult Ixodes ticks are most active.
Ticks search for host animals from the tips of grasses, shrubs, and leaf litter and transfer to animals or persons that brush against vegetation. They only crawl, not fly or jump. Ticks can attach to any part of the human body but often crawl to the more hidden areas to feed such as the groin or armpit and often where clothing is tight. They feed on blood by inserting their mouths into the skin of a host animal. Their bodies slowly enlarge with blood as they feed over several days.
Campers, hikers, outdoor workers, and others who frequent wooded, brushy, and grassy places are commonly exposed to ticks, and this may be important in the transmission of Lyme disease in some areas. Because new homes are often built in wooded areas, transmission of Lyme disease near homes has become an important problem in some areas of the United States. The risk of exposure to ticks is greatest in the woods and garden fringe areas of properties, but ticks may also be carried into lawns and gardens by animals.
There is no evidence that a person can get Lyme disease from the air, food or water, from sexual contact, or by handling wild or domestic animals. There is no convincing evidence that Lyme disease can be transmitted by insects such as mosquitoes, flies, or fleas. Lyme disease infection from a blood transfusion or other contact with infected blood or urine has never been documented.
Ericaceae botanical family
The remedies of the Ericaceae have four characteristic fields of action:
- First they all have rheumatic symptoms and gout. Target organs are joints, tendons, muscles and periosteum. Also pains in chest worse respiration.
- The second topic in this family is the urogenital tract with emphasis on the urinary organs: bladder, kidney, ureters and urethra (inflammations, sand or calculi, with all kinds of pains and colics).
- The third field of action of these remedies is the mind. There often is a kind of weakness even leading to feelings of paralysis of the brain. There are not many mental symptoms; these people often are very basic. They are used to work hard and earn little. As the heather they seem to adapted to survive on poor sandy or sour soils. They do not leave this environment for more fertile territories nor for the city. Mental work is difficult or leads to aggravations of the symptoms.
- Fourth: neuralgias (eyes: Gaul, Rhod, Chim; stomach: Gaul. ao.) and sciatica (Arbu, Chim, Gaul, Kalm, Led) is also encountered in many of them. Ledum extending upward (from the foot), Kalmia downward.
Pains do extend from many organs into the body or limbs; in all directions; crosswise; Ledum extending upward (from the foot), kalmia downward. Also metastasis and shifting symptoms occur in some of the remedies.
Suppressions of eruptions or emotions lead to aggravations; this fits the picture of soft, mild people who are suppressed easily.
There is a strong reaction to weather (amelioration or aggravation for wet, cloudy weather and thunderstorm), temperature (amelioration or aggravation from cold, heat or uncovering) and to motion or rest. (In general most of the remedies are worse from wet weather, cold in general and worse from motion. But there are important differences).
Harry van der Zee, MD
Editor Homœopathic Links
P.O.Box 68
9750 AB Haren
Netherlands