Prescribing for cases with serious pathology
André Saine, N.D., F.C.A.H.
Simillimum 1997; 10 (1) (Spring): 3-24.

When I was a kid, my father's clinic was also our home. In the evening, the treatment rooms would be transformed into bedrooms to accommodate our family of eight kids. At a very young age, I remember roaming in the clinic watching my father examining and treating patients. He would see patients with all types of serious pathology. Many of these cases made an indelible impression on this little boy's mind. One who stands out in my mind was a man who, when he first came to the clinic, was completely bent over in his wheelchair with his head between his knees. Over the years, I saw this man slowly unfold to the point of eventually standing up straight and walking. This was over a period of many years, perhaps six or seven. It was good lesson in patience and perseverance.

The years went by and after graduation in 1980 I started practicing with my father. For my first cases, I would see patients with multiple sclerosis, rheumatoid arthritis, ankylosing spondylitis and cancer. I remember in particular a man in his early fifties with ankylosing spondylitis who had suffered with the most horrible pain anyone could ever endure. Since his late teens he had not had one day free of pain. The pain would start to get worse at night and in the middle of the night he would feel like hot sharp knives going in and out of his back. He responded so well to homeopathic treatment that within about 10 weeks he had become almost completely pain free. For many years after he didn't need any more care, he kept returning to the clinic just to talk with the other patients.

I also remember a two-year old toddler with neuroblastoma grade IV. She had not responded to chemotherapy and her parents were told that nothing else could be done. She was cachectic, just skin and bones. She was carried in in a blanket literally dying and came back about six weeks later with rosy colored cheeks, running in the clinic to the joy of everyone. One of the tumors, about 10 cm, could not be seen anymore.

The next year, late one night while preceptoring with one of my mentors, Dr. John Bastyr, we were talking in his office. The phone rang and Dr. Bastyr picked it up. A man who had just seen Dr. Bastyr on 60 Minutes and was calling for his dying wife who was in a hospital at the other end of the State of Washington. Just new in private practice, I heard Dr. Bastyr giving reassurance and candidly ending by saying "go see Aandrree in Portland. He is closer to you," and he passed the phone to me. I came to realize that he had just referred me a patient with kidney and heart failure because, as he said, she was closest to my office. I didn't realized how bad a state she was in until two days later when I saw the patient coming out of an ambulance on a stretcher. She was semi-comatose and to make things worse she had almost continuous vomiting. I found out that they had given up on her and the husband had been told that his wife had only days to live. With the help of Dr. Bastyr on the phone, I helped the woman make a complete recovery. Seven years later while visiting Portland, I accidentally met the husband who told me that his wife was fine and, on that day, was working in her garden.

All this to tell you that ever since I started my private practice I specialized like my father in difficult cases. Over the years, I have seen patients recovering with homeopathy from the worse conditions possible, cancer, brain tumor, meningitis, kidney failure, heart failure, complete coronary obstruction, epilepsy, schizophrenia, all types of autoimmune diseases including ankylosing spondylitis, ulcerative colitis, multiple sclerosis and scleroderma. Over the years, I could say that I have seen some of the worse cases that anyone could see. I have also witnessed absolutely extraordinary and baffling results.

Statistically, I believe my record speaks for itself. I recall the great homeopaths of the nineteen-century, like Lippe and Wells, claiming no death from pneumonia in 40-50 years of practice. It is totally extraordinary, indeed. On my end of things, I have had about 150 cases of pneumonia, some of the very worst that anyone could imagine seeing, i.e., one case with cancer of the lung abandoned by conventional medicine, one case of pneumocystic carinii pnemonia in an AIDS patient in a coma from meningitis and kidney and renal failure, two cases of comatose infants on their death bed in the last stage of viral pneumonia (they were both in ICU in an oxygen tent), another case with recurrent pneumonia in a kidney and heart failure patient, another case with recurrent pneumonia in a lung cancer patient, one with Aspergillus pneumonia who had become an invalid, emaciated and had been a failure for homeopathy and conventional medicine for 18 months prior to coming under my care, etc. Well, all 150 plus cases were treated with pure homeopathy and have all recovered rather quickly from their pneumonia, without a single death. For me, such results best exemplify what Lippe so rightly said, "if you are true to homeopathy, homeopathy will be true to you."

What have I learned over these years in treating difficult cases? First, the inescapable realization that homeopathy is the most universal and powerful therapy in existence. If a condition, dynamic in origin, is known to be curable by nature it is therefore curable with homeopathy because homeopathy is based on a law of nature. Second, there is always something we can do regardless of the severity of the case. Whether a patient is curable or not depends on many factors, such as the reversibility of the disease process, the will to live, the clarity of the case and also very much the skill of the physician. There are a lot of other factors but these are the main ones.

I have also learned a lot of things that I had never heard about before. At times, I would simply blaze my own trail. Like a pioneer advancing into new lands, I loved every minute of it, further pushing our knowledge of the limits and possibilities of healing. Such work carries its own benefits. It is a great and very satisfying challenge for the intelligence. It is also very satisfactory for the heart, help people regaining their health. It also has permitted my family to live comfortably. Lastly, it teaches us to be wiser by working so closely with Nature for, in healing, Nature is a great teacher by not permitting any lies, fancies or mistakes. I now realize how fortunate I was to have been able to work with two of my first teachers, my father, Dr. Joseph Saine and Dr. John Bastyr. They were great fellows to be around in difficult times with their wealth of experience (a total of 127 years of combined experience).

What can I share with you today? First, that the general principles underlying the treatment of patients with very serious pathologies are on the whole the same as for any other case. A law admits no exception. The need to continuously individualize is the same in all cases. However, Nature does not care whether you know the principles or not and treating these types of patients is the best way to put your knowledge to the test and get rid of any hypothesis, theories and delusions. Many things that I had learned from other teachers didn't pass the clinical test and there were other things I had to find by myself. There were also principles that I had to rediscover as they were rarely, if ever, talked about.

One of these was the phenomenon of dissimilar disease. In my experience, it is absolutely necessary to understand the very complex phenomenon of dissimilar disease in order to deal successfully with complex cases and patients with serious pathologies. Hahnemann discussed the phenomenon of dissimilar disease as early as 1819 in the second edition of the Organon, and it can be found in paragraphs 34 to 46 of the sixth edition. However, throughout the Organon, Chronic Diseases and other works, Hahnemann constantly refers to the coexistence of two or more diseases at the same time in one individual; what he called complex diseases. It is a very important phenomenon, and interestingly, to my knowledge, no Hahnemannian has ever discussed it in any great detail since Hahnemann. Was this subject not further discussed because it was too obvious or because its real clinical importance had not been fully recognized? I don't know the answer but I would assume the latter.

For some reason, as an early student of homeopathy I was under the impression, like my peers, that someone who is sick can only have one disease at a time. I went my way with this misconception until I hit a wall when I started treating patients with serious pathologies. I awoke early to the reality I was facing and started to pay greater attention to better understand this phenomenon.

The great clinical importance of this phenomenon becomes apparent first in the analysis of a case. After having taken a complete case, the first question that should be answered is whether the patient has more than one disease. If the answer is an obvious yes, than the totality of the symptoms is divided according the symptoms of each disease. Therefore, all the symptoms that have appeared since the onset of the last disease should be grouped together. If the answer is no, then all the symptoms related to the single natural disease form a totality. I specify here natural disease, because symptoms related to a causa occasionalis, lack of hygiene or iatrogenicity should not be included in that totality.

Let me give you the example I often use in class to illustrate the phenomenon of dissimilar disease. Let's say a patient with a long standing chronic disease, for example a full blown case of rheumatoid arthritis, fed up with conventional medicine, hears good things about homeopathy and decides to consult you, a genuine homeopathic practitioner. You are quite busy and can schedule an appointment only in a few weeks from now. A week before the appointment the patient takes cold and develops symptoms she recognizes as symptoms of pneumonia that she had in the past: low grade fever, shortness of breath, chest congestion, rusty expectoration, weakness, night sweats, etc. As she knows from her research that homeopathy can deal effectively even with the most severe case of pneumonia, she decides to wait to see you at the scheduled time in a couple days. However, by that time, her condition has progressed to a full-blown case of pneumonia. What is the possibility that she now needs the same remedy as four weeks ago when she first called for an appointment? Perhaps, fifty percent chance or less. The day of the appointment there is ice rain. Her husband drives her to the doorstep of your office before parking the car. As she climbs the three icy steps outside your office, she slips backward and lands violently right on her occiput. Her husband arrives and finds her unconscious. He rings your bell and now you have a complex case. "No problem" is your answer as you are a genuine Hahnemannian. However, the question arises again, what are the chances that she now needs the same remedy for the chronic case with the rheumatoid arthritis, the full-blown pneumonia and the severe concussion? Perhaps less than one percent. It is likely she has three dissimilar diseases requiring three different remedies.

Let me give you another example of dissimilar disease. The wife of one of my best students had an incredibly severe car accident with multiple serious fractures and other serious injuries, such as major subdural hemorrhages, a punctured lung, a ruptured liver, etc. It was hard to believe that she was still alive, because she had fractures of almost every bone in her body, including the cranium, the pelvis, both femurs, tibias, fibulas, feet, clavicles, humeri, jaws, and many vertebrae and ribs. You can see the mess she was in. We gave one remedy for this and one remedy for that. We changed remedies every 15 to 30 minutes over 4 to 8 hours just to keep her alive. Every state was different, one remedy was for the shock of the injury, then there was pain, then there was bleeding, then she was unconscious with stertorous breathing and losing vitality and so on. A colleague stayed around the clock at the hospital for over a week and he would call me regularly with new complications and for advice on what to do. These are some rare conditions where you have to change remedies quickly, as each succeeding state presents a different remedy picture.

The more classic example of dissimilar disease is the existence of a chronic disease with a more recent acute dissimilar condition, such as an acute infection, an acute physical trauma, an acute emotional shock, an acute mental strain, an acute poisoning, an acute indisposition, an acute exacerbation of a chronic disease, an acute periodical disease, or an acute physiological change. There are other situations beside a chronic disease followed by an acute condition in which two or more dissimilar diseases can coexist together, such as in two or more acute or chronic infections, the chronic effects of prolonged exposure to physical, emotional or mental stress, a chronic poisoning, a chronic indisposition, an advanced stage of a chronic disease, complications of a chronic disease, the different stages of certain infectious diseases, or a chronic physiological change. You can now appreciate how crucial it is to understand this phenomenon, regardless of its complexity, for obtaining constancy in clinical success. As you can see, it is applicable in everyday practice.

The question now comes up, how shall we approach a case with two or more dissimilar diseases? The answer is very simple—the same way Hahnemann taught us. Dealing with the more serious, prominent, or latest one first and then with each successively and sometimes even alternatively. But let's be very clear on this, it has nothing to do with routine alternation of remedies, rather it is according to the change of picture and evolution of the case. Of course, the danger would be that the beginner does not recognize this phenomenon or the slightly more advanced practitioner separates every syndrome found in a patient and falsely identifies them as dissimilar diseases. Again, the practice of homeopathy, like medicine, demands a lot of discernment.

Now let's look at some cases from my practice. The first one is probably one of the most interesting cases reported in the history of homeopathy. It clearly demonstrates the different stages in a case of very advanced pathology and how after a few years of trying hard but not progressing I was able at the time of a home visit to unravel the case by making fifteen prescription within about two hours.

On October 5, 1988, a 48 years old woman, physician and mother of four came to consult me with a number of serious conditions including:

1. Intermittent renal and cardiac failure which started in 1970 after her fourth child and has been worse in the last two years. Her main symptoms were dyspnea from slight exertion, pulmonary edema worse in the supine position (she had been sleeping sitting since 1986), chronic cough, pretibial edema, mitral regurgitation (mitral valve prolapse), angina, albuminuria, macroscopic hematuria, brown and scanty urine, recurrent anuria with uremia, nausea, vomiting, exhaustion and decreased mental acuity.
2. Recurrent pneumonia since 1970, once or twice a year with positive culture for Staphylococcus aureus or Hemophilus influenza.
3. Recurrent pyelonephritis two or three times a year since her last pregnancy in 1969 which is associated with anuria, macroscopic hematuria, kidney pain, chills and fever. It is always positive for Klebsiella.
4. Hypertension since her first pregnancy in 1962, average 150/110 but can go up to 200/140.
5. Recurrent barking cough since whooping cough at the age of 4 or 5.
6. History of eclampsia with her first pregnancy in 1962, and preclampsia with the subsequent 3 pregnancies. She has had albuminuria ever since.
7. History of recurrent epitaxis and hematemesis since childhood. She bleeds easily from small wounds and around her teeth.

GENERALITIES:

Temperature:
She is chilly (2). She likes a warmer room with cool air on her face. Since her first pregnancy her face and the palms of her hands are hot (3) most of the time. She has ice cold hands and feet at first at night but they are hot by the morning. She desires cool air but keeps the window closed due to her chest condition. She has been worse from the heat of the sun (2) for the last 10 years. She then becomes weak with a hot face and hands and palpitations. She is worse before a storm (2) with oppression of the chest associated with dyspnea and coughing. She does not perspire much. She has bony dry hands.

Energy:
She is excitable and enthusiastic but easily collapses after excitement. She has had low energy since her first pregnancy: 3-4 on a scale of 10. Her energy is better in the morning, better after eating and worse from the slightest exertion.

Sleep:
She sleeps on her right side only. She develops dyspnea and a cough if she lies on her left side (3) or on her back (2). She uses many blankets.

Appetite:
She experiences nausea with hunger around 11 a.m. and noon. She desires spicy (3), salty (2), butter (2), cream (2) and ice cream (1). She has an aversion to milk (3). When she becomes sick she desires refreshing things, the sicker she is the colder she wants them. Her thirst is average, at times she prefers for cold at other times warm drinks.

Menses:
Always scanty. She is very apprehensive before her menses (2).

Personality:
She describes herself as easy going and outgoing. However, when she is sick she does not want any body around except her husband—at which time she wants to be held. She is extremely excitable and enthusiastic or can be in the opposite state of indifference. She tends to overdo everything. She jumps into it with both feet. She is sympathetic (3). She talks too fast and too loud. She needs excitement but becomes sick with it. She worries (2) about money, her husband, patients and friends. She has fear of all animals (2), especially horses (3), violent weather, thunderstorms (1), arguments, violent atmosphere and men (1). She becomes emotional easily, but rarely cries. She tends to be jealous (1). She becomes drained from being sympathetic to others.

Past medical treatment:
She was treated with allopathy at the beginning of her condition in the sixties. Then she started homeopathic treatment in 1970 and periodically she kept using allopathic medicines palliatively, which included Prednisone, Ventolin, Lasix, Digoxin, antibiotics and Nitroglycerine. As her condition has been getting progressively more serious in the last year, her homeopathic physician of 18 years felt that there was not much he could offer her anymore.

Summary of the case from October 5, 1988 until June 7, 1992:
During the next 3 1/2 years I talked to her on the phone on an almost daily basis. Sometimes, even 3-4 times a day. To give you an idea of the difficulty of her case, I looked at random at the month of March 1991. I calculated 124 written prescriptions, 98 of which where followed by favorable results, 16 were without any changes and 10 prescriptions were unaccounted for. She would reach me wherever I was, whether at the office in Toronto or in Montreal, or my home in Ontario or in Montreal, or in my study or on the road. She would usually find me. She went through several crises of complete anuria, uremic coma, pulmonary edema, pneumonia or acute heart failure. Often she was so weak that I could barely hear her whisper. Because of her weak state and her lack of mental acuity I would have very few symptoms to go on. For instance, when asked about modalities she would often answer I don't know from indifference and lethargy.

Throughout this time, I did my best to find which remedy could fit the few common symptoms she would develop. After a while, I could recognize the remedy she needed just from the concomitance of two or three symptoms. For instance, whenever she would become chillier and she would feel the coldness more in her left arm it would be an unmistakable sign for Carbo vegetabilis. She always pulled out of crisis even though it was often in extremis. Between the crises, I was trying to find deeper remedies that would prevent further crises. It went this way in and out of crises, more often in than out, the crises got more often, longer and more severe until about June 7, 1992. At that time, I received a call from her husband telling me that he thought the game was now over.

Over the years, her husband, who was also a physician, had called at least two other times telling me that he thought that she had come to the end of her rope. But this time he said emphatically, "this is it." She had not urinated in 72 hours. She had been in a solid coma for the last 24 hours and had stopped responding to the remedies. As it was Saturday, I decided to pay her my first home visit, as she lived about 1 hour and 15 minutes without traffic from my home. Unfortunately, I can not find the record of that visit. So I have tried to reconstruct it to the best of my memory and from relying on the rest of the records to associate the different stages or symptoms belonging to each remedy.

When I arrived in her room she was there lying propped up in bed. Her face was white like a sheet. Her hands were cold and also very pale. Her lips and the tip of her fingers were cyanotic. Her breathing was barely perceptible; every minute or so there was a very small and short puff. She had advanced anasarca. By that time her weight was probably around 41 kg (90 pounds). When I first saw her in October 1988 she weighed 61 kg (135 pounds). Edema doesn't become obvious until about 5 kg (10 pounds) accumulation of fluid—and with the anasarca she must have had about 10-15 kg (20-30 pounds) of extra fluid, so she was really 27 kg (60 pounds) of flesh and bones.

Ass.:Because of the puffing respiration in the state of unconsciousness I decided on Opium.
Plan: Opium CM.
Response: Within about 15 seconds her lids started to mildly twitch. Another 15-30 seconds later, her lids started to open and close. Within about one minute of the dose, her eyes were open, staring into open space. Another 30 seconds later, she smiled as she perceived her husband standing at the foot of her bed. Then, I asked her if she could hear me. She nodded yes with her lids. I asked a direct question whether she needed air. She answered again in the affirmative by nodding her lids. I was now able to perceive that her eyes were yellow.

Ass.: Over the years, I had learned that if, after Opium, the cyanosis remained with the craving for air, Carbo vegetabilis was unmistakably the indicated remedy.
Plan: Carbo vegetabilis CM.
Response: Within less than a minute, the cyanosis faded away and she became more alert and vital. I then turned to her husband, who was also a physician, to explain the differentiation of the last two remedies. During that short amount of time, a minute or two, she slowly relapsed into coma. So I started again with the two steps previously done, Opium followed by Carbo vegetabilis. She returned to her more vital stage.

I then had to find the remedy of the next stage. I started to ask whether she had pain, mentioning different places. She was able to nod me into the fact that she experienced a pounding pain in her head and chest. Prior to reaching the uremic coma, she would often have congestion of the head and chest.

Ass.: Glonoinum corresponded perfectly to this late stage of uremia with congestion of the head and chest, characterized by intense pounding pain.
Plan: Glonoinum 50 M.
Response: The pounding disappeared and she was left with a constriction like a squeeze around the head. She started to experience nausea with heart and kidney pain. These were likely the symptoms she had experienced prior to the Glonoinum stage.

Ass.: I had learned in the last 3 1/2 years that these symptoms with her corresponded to Crotalus horridus. If there had been an absence of kidney pain then she would not have responded to Crotalus horridus but more likely to Digitalis.
Plan: Crotalus horridus 50 M.
The kidney pain abated and she felt better. However, she started to desire more air.

Ass.: Over the years, I had noticed that there was a constant succession of stages and also of remedies. And when the desire for air would be present she would respond to no other remedy than Carbo vegetabilis.
Plan: Carbo vegetabilis CM.
Response: She is feeling much better and the desire for air is gone. However, she started to experience chest pain extending to the throat, both trapezius muscles, and upper back, with nausea and chilliness.

Ass.: Now for the first time, the chilliness is a factor, likely indicating a change of picture. With the radiating pain to the throat, both trapezius muscles and the upper back we now had a picture of Naja.
Plan: Naja CM.
Response: She is feeling better. The chest pain is now different. The pain now radiates to the left arm, with a heaviness and a sensation as if the left arm was paralyzed, a paralytic heaviness of the left arm. The nausea is worse.

Ass.: I also learned that beside the appearance of new symptoms a change of stage could be as subtle as one symptom becoming less while another one was becoming more prominent. Also each time that the nausea would get worse with heart symptoms it was always a cardinal sign for Digitalis.
Plan: Digitalis CM.
Response: The nausea and the pain in the arm are better. The chest pain is now different. Her heart is now pounding and she is feeling congestion building up in the head and grasping sensation at the throat.

Ass.: Again, the grasping sensation at the throat associated with a building up of congestion were indication for Glonoinum.
Plan: Glonoinum 50 M.
Response: There is no reaction to the remedy. The symptoms are the same except that she has started to feel that overpowering sleepiness.

Ass.: I had also learned over the years that when she didn't respond to a very well indicated remedy there was a strong possibility that the prescription came too late and she had already passed into a later stage. The overpowering sleepiness was a sign that we were back to Opium.
Plan: Opium CM.
Response: The sleepiness is gone but the previous symptoms are worse.

Ass.: We are going back to the previous picture.
Plan: Glonoinum 50 M.
Response: The heart and head symptoms have abated. The nausea is now worse and the kidneys are more painful. She is somewhat alert but not quite normal, not thirsty, not emotional, quiet and stable. She still has not urinated in over three days.

Ass.: The progression form uremic coma, to heart symptoms to mainly kidney symptoms is progression in the right direction.
Plan: Apis CM.
Response: Finally she started to urinate. She feels better overall and more alert. However, the nausea is unchanged and the kidney pain became worse after she had started to urinate. She is experiencing a deep ache in the kidney area that radiates to the abdomen and thighs. She feels her chest becoming congested.

Ass.: I consulted the repertory to find kidney pain radiating to abdomen and thighs. Only three remedies share these symptoms: Berberis, Nux vomica and Kali bichromicum. Nux vomica was eliminated because of her quiet disposition. Berberis was also eliminated from not having the symptom of anuria.
Plan: Kali bichromicum CM.
Response: She feels very much better. The kidney pain is almost completely gone. The nausea is also much better. The lung congestion is a great deal better. However, she started to develop a cough which is worse talking and worse breathing with a mild burning pain in the left lower lung area. She feels an internal chilliness with heat in her face and palms of her hands. She has become thirsty for cold drinks.

Ass.: We have now a clear picture of Phosphorus.
Plan: Phosphorus MM.
Response: After Phosphorus she felt much better. She urinated again. I waited for some time and as she was stable, I left, leaving clear instructions to her husband. That home visit lasted about 2 hours. After my departure, she began urinating great quantities. She slept very well that night without waking. She started to progressively regaine her health. She needed to be prescribed for only twice over the next two months. Then it became even less often as she was regaining her health. She started part time work and eventually went back to full time practice. I last prescribed for her in April 1995 and saw her last during a professional meeting in May 1996. As far as I know she is still well now, February 2003.

CONCLUSION :

This is a remarkable recovery from a disease that had plagued her for over thirty years. I can ascribe this sudden success to, first, having been able to be at her beside and assist her through the different successive stages quickly, and second, to have been able to recognize the different stages from having learned them all from years of prescribing for her. I don't recall any case in the literature of such a recovery where the patient went so clearly through stages of organ failure. It is a perfect case to illustrate how each different stage can be dissimilar.

November 3, 1987:
In the fall of 1986, PD., a 37 y.o. homosexual male, consults his family physician for a persistent dry cough of 10 months duration. Oral antibiotics are prescribed. PD. then develops a persistent diarrhea with continuous and debilitating pain in the left hypochondria. Various medications are prescribed to no avail.

In February 1987, PD. has now lost 13 pounds at which time the HIV antibody test is found to be positive. During the summer of 1987, he complains of a recurring sore throat, cough, fever and night sweats which are particularly profuse from the knees down (Croc., Ars., Merc., Nit-ac., Thuj.). He develops a severe case of oropharyngeal thrush with a hairy tongue. He continues to slowly deteriorate with more fever, sweats, sore throat, exhaustion, further loss of weight in spite of consulting with two AIDS specialists, one naturopathic physician and a Chinese herbalist. In mid-September he develops a strep infection. After a new course of antibiotics he develops an allergic rash. Two weeks later he is hospitalized with pneumocystis carinii pneumonia (PCP).

Septra, an antibiotic, is given IV. around the clock. A long series of adverse reactions to medication follows. Two weeks later (now mid-October), he is released having somewhat recovered from the pneumonia. During his last 2 days in the hospital he had started to experience heaviness of the head with achiness of the eyes. Three days after his release, PD. is readmitted for acute cryptococcal meningitis, a very insidious and often fatal form of meningitis. Amphotericin B is given IV in high doses around the clock. Another antibiotic, flucytosine is given orally. Lastly, 1OO mg of corticosteroid is added to the IV antibiotics to counteract the severe adverse effects of antibiotic therapy which PD. experiences as severe headaches, nausea, vomiting, cramps, spasms, fever, photophobia and general weakness. PD's condition further deteriorates in the following week. He is vomiting several times a day, a green-brownish vomitus and develops pitting edema in both legs with persistent kidney pains (One of the most serious adverse effects of amphotericin B is kidney failure). His liver is enlarged and tender. His hemoglobin is 6.0 and Potassium 2.7 mmol/ (N: 3.5.-5). The general pains are so severe that morphine is administered and the physicians advise the family and friends that PD. is not responding to the therapy and they can expect the worst.

Late in the evening of November 3, I received a phone call from PD's friend asking if homeopathy could help at this time. I take PD's case on the phone. Here are the characteristic symptoms described by his friend: He is semi-conscious with incoherent speech, extreme weakness with great restlessness and fear of dying. He desires company and he has cracked lips, extreme sensitivity to light and the slightest noise, especially voices.

Ass.: Prognosis is fair because the remedy is so well indicated.
Plan: Arsenicum album 30 C every two hours.

November 4:
The first dose of the remedy was given at 1 p.m. during complete unconsciousness. Fifteen minutes later he is said to have smiled. Soon after, his overall condition improves dramatically.

November 5:
He is hungry and eats his first 3 meals in 6 weeks to the total amazement of the "assisting" medical staff.

November 8:
His general condition continued to improve until this morning. Now he is experiencing the following characteristic symptoms: dryness of the tongue with loss of taste worse on waking, burning soles, painless diarrhea early in the morning and burning itching hemorrhoids. The pain in the kidneys and liver and the edema of the lower extremities are still unchanged.

Ass.: We now have a change of picture. Sulphur is here clearly indicated.
Plan: Sulphur 30 C three times a day.

November 11:
His general condition continues to improve until this morning. He is relapsing into the first state, i.e.: great weakness with restlessness and fear of death.

Ass.: Relapse of the first stage.
Plan: Arsenicum album 200 C every four hours.

Later that day, I am able for the first time to talk directly to the patient on the phone. I suggest that the best chance for him to recover, not only from the present condition but also from the chronic disease of general immune deficiency, is to first stop the steroids and later the antibiotics and to leave the hospital. P.D. is very reticent to stop the drugs but with the encouragement of his friend he agrees. So, on the evening of November 11, the steroids are stopped.

November 12:
P.D. now experiences the severe side effects of the antibiotics which had been checked by the steroids. The symptoms are great chills with very high fever worse from slight uncovering and from motion, very nervous and irritable from any external impression and he wants to be alone. Potassium: 3.0 mmol/L.

Ass.: We have a change of picture clearly indicating Nux vomica.
Plan: Nux vomica 200 C every two hours.

His general condition improves further; he eats and smiles. The doctors and nurses are rather puzzled at the changes and think that the antibiotics are working after all. The infectious disease specialists are still pressing P.D. to take the oral antibiotic flucytosine that P.D. had previously asked to be stopped. P.D. refuses.

November 14:
Serum potassium is now 3.5 and the hemoglobin up to 8.7.

November 16:
The symptom picture has again changed: he has profuse night sweats, sleeplessness, loss of appetite, and burning /itching hemorrhoids.

Plan: Sulphur 30 C three times a day.

November 17:
He feels better and informs his doctors that he wants to leave the hospital within a few days. The night sweats have stopped and the appetite has returned. The serum potassium is now normal at 4.2 mmol/L. By the evening, the symptomatology changes: he has a high fever with aversion to uncovering, thirstless during the heat and perspiration of the left side of the body only.

Ass.: We have a clear picture of Pulsatilla. Plan: Pulsatilla 30 C every four hours.

November 18:
He feels better again. A lumbar puncture (LP) is performed to assess the state of the CNS infection. The cryptococcus is still present in the spinal fluid. His hemoglobin is now 9.0. PD's state is stable but he suffers from severe headaches (since the LP), which are better by stooping.

Ass.: I interpreted the symptom in the repertory of headaches worse tapping on spine as headaches from tapping the spine.
Plan: Cina 30 C every two hours.

November 20:
The headaches stay unchanged after the last prescription. PD. stops the antibiotics against all medical advice. He still had 4 more weeks of IV antibiotic therapy to complete.

November 21:
This morning, PD. leaves the hospital. He is told that, without a doubt, the meningitis will become fulminant and that he will die within a few days if he does not resume the antibiotherapies. By 11 a.m. the symptoms of meningitis are returning rapidly: heaviness around the eyes, rigidity of the neck, headache which is worse from flexion, sensitivity to light and slight noise especially voices, very irritable worse if spoken to, chilliness, restlessness, incoherent speech and great weakness. He does not drink but often wets his cracked lips with warm water.

Plan: Arsenicum album 30 C every two hours.

Two hours later his general condition improves again. He continues to improve until the morning of November 25 at which time he experiences a mild relapse.

Ass.: Same picture but relapsing.
Plan: Arsenicum 200 C every two hours.

He started to smile 5 minutes after receiving the first dose and within 10 minutes fell asleep for 45 minutes. His energy is much better and most of the symptoms are much less. By 7 p.m. he is experiencing a relapse again: heaviness of the head which is worse walking, eye pain worse looking upward, irritability and desire for salt and sweets.

Plan: Sulphur 30 C every two hours.

November 27:
Within 15 minutes after the first dose, his energy picked up, he got up, smiled and went to the refrigerator as if everything was normal. On the morning of November 27, he was feeling good enough to have his chronic case taken on the phone. He describes himself as a loner, a shy and introverted person who prefers to be by himself. He worries about the future and disease (2), especially about contagious diseases (2). All his life he has had fear of microbes. He is fastidious about cleanliness (3) and conscientious about trifles (2). He has vertigo in high places (1) and has fear of the dark (2), death, narrow places and of public speaking (2). He dwells on past disagreeable occurrence. He is chilly (2) worse cold room. He desires farinaceous (2), meat (2), salt (2) and garlic. His face and back are oily and he has tendency for hangnails.

Ass.: No clear differentials but the closest remedy looks like Natrum muriaticum.
Plan: Natrum muriaticum 30 C one dose.

November 29:
Within one hour his energy picked up and the overall picture improved. He continued to improve until the morning of November 29. He wakes up almost in a state of stupor, with great heaviness of the head, very irritable, frowning, melancholic, talks about his homeland, very slow to answer (3), aversion to company, reproaches himself, thirsty for cool drinks and has the sensation of a hair in the throat on swallowing.

Ass.: He has a relapse of the meningitis with a clear picture for Helleborus.
Plan: Helleborus 30 C every hour and then as needed.

December 10:
His energy soon returns, the stupor disappears, the appetite returns and he starts to read and be active. An eczematous eruption has appeared on the leg, a symptom which he has had for the past 3 years until about 10 months ago. He took the remedy about three times a day and continued to improve until December 10. Coryza after eating, heat of the face with coryza, throbbingheadache on stooping and desire for meat and fat.

Ass.: A clear change of picture.
Plan: Nux vomica 200 C every six hours.

December 16:
He improved until today. He now experiences pain at the root of the nose, dryness of the throat on waking and expired air feels hot (3).

Plan: Kali bichromicum 30 C three times a day.

December 27:
By now, he is well recovered.

Plan: Stop the Kali bichromicum and wait.

December 30:
He is very chilly (3), irritable when questioned (3), and has despair of recovery (3), fear of death (3), but desires to be alone (3).

Plan: Nux vomica 1 M one dose.

On January 12, 1988:
I meet PD. for the first time. The eczema has now erupted in both external ear canals and has spread to the left leg. He has been chilly in the last 2 weeks on the left side of his body only (3), heat after eating (2) and great loss of hair (3). I further investigate his chronic case now that he is more coherent. He has never felt normal, has felt different and excluded, conscientious about trifles (3), chronic worrier, very self conscious, anticipation (3) and lack of self confidence (3). He hates himself. He is uncomfortable in the presence of others from being constantly humiliated and diminished since early childhood by his father. He was told repeatedly that he was good for nothing. He hated his father until a few years ago when he died. He suppresses his anger and refuses consolation. Since the age of 3, he has had diarrhea with tympanic distension every day before going to school or when anxious.

Plan: Lycopodium 6 C four times a day.

January 27, 1988:
PD. feels much better overall. He feels more normal. Within a week of taking the last remedy, he felt less anxious, less irritable, much less obsessed about trifles and stronger. He feels warmer and now desires the open air. Hair falling is less with itchiness and offensive discharge from the scalp. The eczema has now spread upwards to the waist. The serology shows the sedimentation rate at 55 mm/h, the hemoglobin at 10.7 and the liver enzymes are normal for the first time in months.

Plan: Lycopodium 6 C four times a day.

February 9, 1988:
He feels "normal". He feels strong. The mind is clearer. He is less irritable and more self-confident. The scalp and the eczema is worse. He desires open air (3). Plan: Lycopodium 6 C four times a day.

February 18, 1988:
He is relapsing. He has difficulty to think, "when I want to think about something the mind goes around it and goes nowhere, I can't focus the mind, the mind is stationary, I can't read or concentrate," staring for hours, throbbing headache, body feels heavy and the eczema is less.

Ass.: He has a relapse of the meningitis.
Plan: Helleborus 30 C every two hours.

February 22, 1988:
He recovered quickly and was better until this morning. Now he can't open the eyes, with great exhaustion and depression that is worse 3-6 p.m.

Ass.: A change of picture.
Plan: Gelsemium 30 C three times a day.

February 24, 1988:
There is no change. Now, he has a sore throat that is worse on the right side, he desires sweets and he was irritable on waking.

Plan: Lycopodium 12 C twice a day.

March 8, 1988: He improved progressively. His energy is much better by walking in the open air and he is weaker in a warm room. He is starting to feel a state of depression which he has had since his early twenties. He feels suicidal (by poisoning). He is angry and breaks things. His hemoglobin is up to 11.3.

Plan: Lycopodium 12 C three times a day.

March 18, 1988:
He feels much better. The depression has lifted and the mind is very clear. His appetite and energy are very good. The eczema is worse, it has now spread to the face. The hair falling is 50% better. Serology of March 10: hemoglobin: 11.4 and ESR: 58.

Plan: Lycopodium 12 C three times a day.

April 5, 1988:
He is feeling pretty good mentally and emotionally. "It seems this remedy provides me clarity. I can think and express myself better." The concentration is good; he can read straight for up to two hours. His energy is almost normal, about 8 out of 10, the best in over one year. He goes out for long walks three times a day and enjoys it. He does one hour of weight lifting every other day. In general all the symptoms are better except for the eczema which has spread upwards from the legs, to the abdomen and chest, then to the neck and face. The face is totally covered by the rash which is very itchy and is worse from undressing and the warmth of the bed. He demands some relief of the itchiness as it is also preventing from sleeping. He has had a watery coryza in the morning for the past 18 days. He has been feeling warmer.

Plan: Sulphur 12 twice a day.

April 13:
The rash and the itchiness are much worse since the last remedy. The head is now affected and there is much dandruff. He feels also much warmer with flushes of heat and night sweats inside the thighs and behind the knees (2). The sleep is less because of the itchiness and he feels more tired.

Plan: Sulphur 12 C twice a day.

April 21:
The rash and itchiness are decreasing. The dandruff is the same with thick brownish scales. He is sleeping 8 hours straight without waking. He had night sweats only last night in the lower back and the legs (between the knees and ankles). The energy is better. He feels good and steady emotionally. He has less flushes of heat. The coryza is unchanged. He was tested this week for syphilis and was seropositive for active infection. He contacted syphilis 10 years ago at which time he had a chancre on the penis.

Plan: Sulphur 12 C twice a day.

Contrary to my advice, P.D. goes to Japan and stops homeopathic treatment. He returns three months later with another PCP. He decides to go back on antibiotics (he was told that these were "better ones"). In late October, I am asked to consult with him for the first time since last April. I visit him in a hospice. His energy is very low. I obtain almost no symptoms from him and find that I am unable to help him. He regresses further. Soon after he develops another cryptococcal meningitis. This time, the symptoms are less clear and he responds poorly. In December, while I am away, he dies in the hospice.

CONCLUSION:

What would have happened if he had continued his homeopathic treatment? I cannot say. What we know is that we treated probably one of the worst cases of compromised immunity in this patient with a full blown case of AIDS, pneumoncystic carinii pneumonia, cryptococcal meningitis, syphilis, high doses of very toxic antibiotics and antifungal drugs, high doses of steroids and lastly morphine. The patient is comatose with liver and renal failure and the question is, "Can homeopathy help?" The answer is that with pure homeopathy this patient was recovering his health quickly until he interrupted his treatment.

C.V., 22 year old. female nursing student.
CC: Neurofribroma

January 25, 1996:
In 1989, C.V. develops severe headaches (Headaches) and is diagnosed with neurofibromatosis (von Recklinghausen's disease) with a brain tumor having grown near the pineal gland. She has surgery to install a shunt. In spite of the shunt, the Headaches have persisted. No medications have been able to reduce the pain. Periodically the tumor is being looked at with magnetic resonance imaging. It tended to fluctuate in size but on the last occasion which was two months ago, the tumor was the same size as in 1989 (10 cm).

The Headaches are constant and become worse in different circumstances. When bad they feel like "someone is banging my head with a hammer." During the Headaches, she is very irritable (2), her cheeks turn red, her vision becomes blurry, she looses her balance and has dizziness, as if the room was spinning or she will fall forward. The dizziness is worse reading or using her eyes (3), worse standing (2) or exertion (1). The Headaches will prevent her from sleeping. They are located in the occipital area and are worse any movement (2), worse lying on the back (2), worse noise (2), better lying with the head elevated (2), better sitting straight (1) and better with cold applications.

She also complained of chest pain since the shunt was moved in February 1994 but it has been much worse in the last five months. It is felt as a sharp pricking which extends to the back and which is worse on inspiration (2), worse expiration (1), worse turning in bed (2) and worse coughing (2). It is O.K. on walking slowly. She also has another type of headache which is located in the temples and over the eyes and appears one week before her period and is aggravated by rich foods (1), better sleep (2) and accompanied by lumbosacral pain which is worse with warmth (1). She has a recurrent acute allergic reaction, four to five times a year, usually related to dust or changes of season. In such times, she develops "burning to death" in the nostril (3).

Past history:
Since 3 years old, she has had a history of asthma that would develop into bronchitis. Now she only gets bronchitis with wheezing two or three times a year at which time she develops a barking cough which is better by drinking (1), worse on laughing (1), worse cold air (1) and worse on waking (1). The cough is dry in the evening and loose in the morning. She gets cold sores in the corners of the lips every year.

GENERALITIES:

Temperature:
She has always been warm-blooded. She never feels the coldness in a house. She wears T-shirts and shorts while others are cold. However, her feet are often cold during sleep. She can be in the sun all day.

Energy:
6 on a scale of 10. Her energy is worse as the day goes on, better with rest and better with exercise (1).

Sleep:
Her sleep is fine but light. She sleeps on the abdomen with just a little blanket. She always gets warm from the neck down and then she will uncover her feet about once every other night. She occasionally perspires on the forehead and lower back during sleep. Since the age of 15 or 16, she has clairvoyant dreams about every month or every other month. The dream "comes through in all its details" about two weeks later and it is usually something bad, for instance, she sees herself driving with her cousin and when crossing a very specific intersection in NYC she sees a blue car of a certain make coming from the right and hitting their car on the front fender. This accident happened exactly as it was dreamed two weeks later. One time she dreamed which was the winner number at the lottery. She verified and the winning number was the one she dreamt but she didn't play it.

Appetite:
She desires chicken (2) and likes onions and spicy. She has an aversion to fish and eggs. She drinks 8-12 glasses of cold fluids a day.

Menses:
She desires chocolate (2) and she weeps easily around her menses. She has "very, very heavy bleeding" for the first two days. She used 32 sanitary pads in the first two days. It is dark red blood with clots.

Personality:
She describes herself as loving, caring, friendly, being a good listener, energetic, happy, striving and hard working. She worries a lot (3): i.e., "what about if the shunt does not work", "what about if I get ill,"... Her only fear is when she goes to the hospital, "If something goes wrong, I will die."

She is sensitive: she cries easily if she sees someone else crying. She gets hurt easily. She does not like sympathy: "Don't pity me, I will be better." Absolutely nothing else is remarkable.

Objective symptoms:
She is a very easy-going person to interview. Even though she expresses her symptoms with great ease she is very vague about their description. She is nonchalant. She is of normal build, slightly on the heavy side. She has a geographic tongue and her pulse is 88.

Ass.: The remedy which covers best the general symptoms characterized by clairvoyant dreams, herpes in the corners of the mouth, thirst for large quantities of cold water, the geographic tongue also covers best the HA symptoms characterized by aggravation when lying on the back, better cold application, lies with the head high and the vertigo worse reading. The same remedy covers best the symptoms of the recurrent bronchitis.
Plan: Phosphorus 200 D one dose.

March 14:
The day after taking the remedy she developed nausea, vomiting and diarrhea. The constant hammer-like headaches have decreased by 50-60 % after the second day of taking the remedy. The blurry vision is 90 % better. The dizziness started to improve four weeks ago, now it is 90 % better. The chest pain has decreased by 60 % in the last 5 weeks. Her sleep has been unusually deeper. The nausea stopped soon after the remedy. The energy has been better; it went from a 6 to 7.5. The appetite decreased by 25 % less than normal three days after taking the remedy. She has been thirstier in the last five weeks; she is taking 15-16 glasses of cold drinks a day. She desires meat less but chicken more. Her menses have been 60 % less copious which is very unusual for her. However, instead of lasting 4 days like usual, the January menses (Jan. 30 to Feb. 7) lasted 9 days and the February menses (Feb. 26-March 2) 6 days. Many symptoms have not changed such as the Headaches before menses, losing her balance, falling forward if she stands for a long time, being moody and temperamental, worrying a lot and the red cheeks with Headaches. The burning nostrils due to allergies have been worse in the last two weeks.

Since February 8, she has developed new headaches which are daily and go from the nape of the neck to the center of her head. They are burning in character, "like fire in the head". They are present on waking and increase as the day goes on (3). They are worse with light (1), worse watching TV (1), worse sitting (2) and better standing (2). These Headaches are associated with a tingling pain which extend down the left arm to the middle three fingers. Since January 29 she has had diarrhea with pasta.

Ass.: Very good reaction: an initial aggravation followed by a prolonged and general improvement.

There is the appearance of new symptoms which are still well covered by Phosphorus.

Plan: Phosphorus 200 D one dose.

April 10:
Her menstrual cramps are 90 % better. The burning Headaches are the same. The hammering Headaches are 75 % better. The blurry vision is gone. The loosing balance is 50 % better. The mood and temperament have been better. The dizziness is gone. The falling forward is 60 % better. The nausea is present every other day. The appetite is still low. She has lost 10 lb. in the last 6 weeks. She is down to 120 pounds (55 kg) while her best weight is between 130-135 (59-61 kg). The chest pain has been less. She is able to do more activity. The allergies are gone. The increased thirst is the same. The energy is the same at 7.5. She does not uncover her feet anymore but she still gets too warm in sleep. She has been sleeping with a lighter blanket lately. She does not worry anymore.

Ass.: She is much better but the new Headaches are still persisting.
Plan: Phosphorus 1 M.

April 15:
She has not yet received the remedy and the Headaches are getting worse.

Plan: Phosphorus 200 D in water one dose and take Phosphorus 1 M when she stops improving.

April 29:
She took the first remedy in water two weeks ago and the nausea, the loss of balance and all the Headaches disappeared. Then she took the second remedy on April 23. The next day she developed a bronchitis associated with a dry barking cough. She used to have this as a young child with seasonal change. She has sharp pain in the upper chest that is worse from coughing (2). The cough is worse when she lies on her back (3) and better lying on her side. The thirst is not has excessive. She drinks 10-12 glasses instead of 15-16. She still has premonitory dreams. Her energy has been higher at nine. She stopped uncovering her feet since the remedy in water but she still gets too warm in sleep. She also stopped worrying.

Ass.: Excellent response to the remedy. Now she has the return of the old bronchitis.
Plan: Phosphorus 1 M twice a day for two days.

May 21:
The bronchitis and the chest pain disappeared quickly within three days. One week after the remedy she was very nervous, impatient and agitated. It lasted two weeks then she started to be calmer than usual (20 %). Her energy has been higher: 9-9.5 in spite of sleeping less. She has been studying for her final exam. She goes to bed later, 1-2 a.m. instead of 11 p.m., and wakes up earlier, 7-8 instead of 8-9 a.m. Now she sleeps without a blanket, just a T-shirt and with the fan on. The dreams are the same.

Ass.: Very good reaction.
Plan: Wait. Repeat Phosphorus 1 M at the first sign of a relapse. Mail to her Phosphorus 10 M and 50 M.

July 17:
She has not taken any remedy. She is doing fine and has been symptom free. She feels even calmer (80 % less than usual). Her energy is 9-9.5.

Ass.: She is still improving and doing very well.
Plan: Phosphorus 10 M one dose to see if it will disturb the case or increase the speed of her recovery.

August 2:
She was doing well until two days ago. She developed a pounding HA which wakens her at 3 a.m. and prevented her from sleeping.

Ass.: It does not seems that there was any reaction to Phosphorus 10 M.
Plan: Phosphorus 10 M once a day for four days.

Summary of the case until March 5, 1997:
The Headaches disappeared quickly. Since, she has had very mild signs of relapse that disappeared quickly with another dose of the remedy on October 2. She went up to the next potency on October 22. Soon afterward she developed an eczema like the one she used to have at the age of 7-8 years old. She repeated the remedy in the 50 M on January 7, March 5 and May 20, 1997. The eczema disappeared about 6 months after its appearance. At her last two appointments she was asymptomatic with her energy at 8.5-9. I have never talked to her since but regularly talk to her aunt who referred her to me. She says that she has been doing well until now, Spring 2002.

CONCLUSION:

In spite of the size of the tumor, she reacted quickly and permanently to the remedy. For some reason or another, she was never able to obtain the reports of further MRI and cat-scans.

J.W., 79-year-old man, retired administrator.

C.C.: Sudden paralysis

October 18, 1992:
For his age, J.W. is a very active man that has maintained an unusual level of physical fitness. He has been under my care since 1988 especially for high blood pressure, which he had had for at least 20 years. In July 1992, he injured himself and had to slow down his usual very active schedule. One afternoon in late August after working out heavily in the morning, he walked 30 km in the hot humid weather. He apparently developed heat stroke, as the following two days he became very weak with vomiting. He seemed not to recover from this event as he lost 15 pounds within the next 8 weeks. Then on October 11, he developed flu-like muscular pains in his back and extremities with a shuffling gait and with his arms hanging. The next day his left upper arm was completely paralyzed. The following day his right upper arm became completely paralyzed. Afterwards, the paralysis progressed to the lower limbs to the point that he became almost completely paralyzed. On Friday October 16, his GP sent him to a rheumatologist who ruled out polymyositis. As the condition was still progressing very rapidly day to day, his wife phoned me late on Saturday night asking for my opinion. As I sensed the seriousness of J.W.'s condition and the urgency of dealing with it ASAP, I told them that I would see them the next day in class as I was teaching that day.

Presenting symptoms:
He experiences muscular pain in his thighs, "like a constant throb, like a toothache", which is better from warmth (1); muscular pain in the nape of the neck ascending to the occiput, like during the flu; both arms down to the fingers are greatly paralyzed. His voice is weak and husky; at times he can barely speak. He can't sit up or stand without help. His hands and feet have been ice cold in the last week. He is very chilly, and he can't be warmed up. He shivers from slight movement or if he rolls over in bed. A draft chills him right through.

His appetite and thirst are normal. He has been sleeping poorly especially in the last two weeks. He wakes up after 2 hours of sleep and stays awake for the rest of the night until the early morning hours. He may then doze for 1/2-1 hour. When I asked him how he was feeling emotionally, he broke down in tears, saying: "I am completely upset the way my life has turned. Frustration—unable to be normal—imprisoned within yourself."

Past medical history:
J.W. felt that he had enjoyed a relatively good level of health until his hypertension became symptomatic in 1985 for which he was treated without much success with allopathy. He first consulted me in June 1988 essentially for hypertension but also for ulcer-like stomach pains, bloating of the abdomen, eructations when anxious, involuntary stool when passing flatus, cramps in his thighs at night and ringing in his ears for the last 20-25 years. He had described himself as a very impatient person with the tendency to become very easily angered with contradiction. He was a perfectionist with low self confidence and fear of failure. He worried about his children and his health. He had become quite chilly over the years. He would snore heavily at night and had mild nocturia. He craved meat and sweets and had an absolute aversion to vinegar. He was treated successfully with Nux vomica and then with Lycopodium. His blood pressure progressively came down from about 200/100 to about 165/90. He developed a sense of well being and all his other symptoms disappeared except his tendency to become angry at contradiction, which was only improved. Eventually he became, for the first time since young adulthood, greatly intolerant to heat with easy perspiration, developed itchiness of his forearms and ankles in the evening and started to strongly crave apples ("I ate them by the bushel prior to being married over 50 years ago"). With these symptoms he was then prescribed Sulphur and his blood pressure when down again and he continued to feel well. Prior to this acute episode of paralysis he was last seen on December 19, 1991 feeling quite well.

Objective symptoms:
With his head and shoulders low, the look on his face was that of a defeated man, sunken within himself, like a dry raisin. Physical examination showed no sensory changes. All his muscles in his limbs are very weak, having lost up to 80% function in his four limbs. He can barely move any fingers. He can't rise from a chair by himself but can still shuffle to walk a small distance. He can't ascend or descend stairs. He lost complete flexion of his thighs. He is areflexic in his upper limbs. The patellar and Achilles' reflexes are weak.

Ass.: It looks like a viral infection, perhaps Guillain-Barré. There are many characteristic symptoms and the most characteristic are pain in paralyzed parts, better from warmth, chilly—can't be warmed up, worse from the slightest draft, worse turning in bed, irritable, frustrated. Very clear case of Nux vomica and therefore the prognosis is good in spite of gravity of the problem.
Plan: Nux vomica 10 M now and before bed. If no improvement by the morning or if relapse, repeat. I insisted that they phone back the neurologist right away for a possible diagnosis of Guillain-Barré but avoid treatment or admission in hospital until they talk to me.

October 19:
He took the remedy at 5 p.m. By 7:30 p.m. he experienced sharp pains in his thighs then he fell asleep at 8 p.m. and slept until 10 p.m. at which time he repeated the remedy. He then felt a funny feeling in his right arm and a tremor from his abdomen upwards. He went back to sleep and slept until 8 a.m. As he felt the same at that time he repeated the remedy and went back to sleep until 9:30 a.m. He then noticed that he was walking better and he looked better. He could raise his right arm to his face, the left arm was looser and he was looking better. He saw the neurologist who insisted that he stays in the hospital. He had to sign a release consent that he was leaving the hospital against all medical advice and that his life was at great risk.

Ass.: Very good response.
Plan: Wait and repeat as needed.

October 20:
He slept better last night. He slept from 10 p.m. until 4:45 a.m., then from 5 a.m. until 9 a.m.; had breakfast, slept from 10 a.m. until 12 p.m.; had lunch and slept from 3 to 4 p.m. The pains are 75 % better. Now he can move his left arm up to his nose and his right arm to his head. His voice is better. His hands are 50 % less cold. He is less chilly. He is less upset. His energy is the same. His walking is better.

Ass.: He is still improving.
Plan: Same.

October 27:
On October 23, the diagnosis of Guillain-Barré syndrome (acute polyneuropathy) was finally delivered. Three different specialists and his GP tried to convince J.W. and his wife that by not accepting hospitalization he was severely endangering his life. He was notified of the very high mortality rate for people of his age group. They were recommending plasmapheresis and gamma globulin therapy. All the pains have been gone since October 24.

Ass.: He is still improving.
Plan: Same.

October 29:
He has been much better day by day. He is walking better. He has been able to get up by himself. He has been able to bring his right hand behind his head and his left hand to his chin. His voice is now almost normal. He still can't dress himself or eat soup or drink by himself. His temperament has been much better, "there has been no agonizing or railing". His blood pressure has been quite reasonable at 160/88.

Ass.: He is still improving.
Plan: Wait, if relapse Nux vomica 50 M.

November 1:
He has been stable for the last two days.

Ass.: Stable.
Plan: Take Nux vomica 50 M.

November 5:
He made "quite a bit of progress afterwards." He has been sleeping 10-12 hours per night. He is more relaxed. His right arm is now quite free. All the pains are gone. His walking is better but he still has to lean against the wall. He can partly dress himself. He can move his fingers a bit more.

Ass.: Good progress.
Plan: In spite of the patient continuing to improve, let's give another dose to see if progress will increase or decrease.

November 8:
"This dose settled me down." He can move the right hand half way and the left hand 1/4 way. When sitting he can now cross his legs with a little help from his hands. His energy is almost back to normal. He has been able to shower by himself. He has been able to eat by himself except certain foods or the last parts of the meal. He still needs help to dress himself but to a lesser degree. He is not sensitive to drafts.

Ass.: The patient further improved.
Plan: Wait.

November 17:
He improved until November 11. He is now able to come down the stairs by himself. He can shave by himself. He can get up at night by himself. He was stable until November 14 when his legs started to feel weak and the pains started to return for the first time since they had disappeared two weeks ago. The remedy was repeated at 5 p.m. on November 14. By the next morning he was much better. His legs were stronger and the pains were gone. He has been slowly improving since. He has been sleeping more since this last dose. He can now open his right hand 2/3 and his left hand 4/5. His reflexes are starting to reappear for the first time. The neurologist phone last evening "wondering if he was still alive." On November 15 he slept most of the day until early evening.

Plan: Wait, if relapse Nux vomica CM.

Summary of the case from November 17, 1992 until July 19, 1994:
John has continued to steadily improve. It took a long time for him to regain full abduction of his left arm. As of now he is about 99% recovered. He has regained all his muscle strength and tone. He is still missing 25 degrees for full abduction of his left arm but here it seems to be more related to a partially ankylosed shoulder from the prolonged inactivity (frozen shoulder). He has regained full range of motion of his hands. The dorsiflexion of his fingers eventually returned to normal. All the reflexes are normal. He has regained his full body weight and returned to the same busy and industrious schedule as prior to this polyneuropathy. His wife has repeated on different occasions "What would have happen to John if I had not phoned you on that Saturday night?"

CONCLUSION:

In spite of the seriousness of the condition and his advanced age, the patient reacted quickly and very well to the indicated remedy.

August 15, 1997:
J.W., 5 1/2 year old boy, started to show gross hematuria on April 1997 that continued every day. He was examined by a few nephrologists. On examination the red blood cells (RBC) were dysmorphic and there was the presence of RBC casts. As it was a hematuria of a glomerular origin, he was diagnosed with a primary idiopathic glomerulonephritis (IgA nephropathy or Berger's disease). The prognosis became unfavorable as the hematuria persisted. Within 10 years such patients develop renal failure. In such cases conventional "interventions have proved to be disappointing."

When I saw J.W., he already had been under the treatment of another homeopathic practitioner who had given him Apis, Thuja, Natrum muriaticum, Belladonna, Mercurius corrosivus, Staphysagria and Tuberculinum in the 200 C potency. He said that J.W. responded to many remedies but he had not yet found the simillimum. The hematuria was persisting.

What I found out is the following: J.W. had had asthma since the age of 1 1/2 years old. The past medical history revealed that when J.W. first had cow's milk at one year old he became pale and limp. He has been kept off milk products ever since.

However when he gets dairy products by accident he develops a severe allergic reaction. At 1 1/2 y.o., he developed asthma. The asthma kept getting worse with time. Each upper respiratory tract infection is followed by an aggravation of the asthma; also if he eats dairy products by mistake. On April 3 1997 he had a severe asthma attack. He was treated heavily with conventional medication, following which he developed a red rash, which started on the face and extended throughout the body. He was treated with Benadryl without success. That is about when the hematuria started. With the asthma he becomes weak and tends to be quiet. It usually starts to get worse around 8-9 p.m. and continues throughout the night. He can have an asthmatic rattling cough all night which is worse as soon as he goes to bed (2), worse change of position (2), worse exertion (1) and better sitting up (2) and from warm drinks (1). The cough can be worse at 3 a.m. The most peculiar concomitant with the asthma is that on a few occasions he developed vesicles on the surface of one eye. He tends to have recurrent strep infections, same as his six other brothers and sisters.

GENERALITIES:

J.W. is a timid, yielding and very reserved boy. He has had a very pale complexion ever since birth. He is described as being always obedient, a good child. He likes to be cuddled. He is smart. He tries his best in school. He is not a leader. He tends to be sensitive to injustice at which time he will get angry and may throw something. He is sensitive to a sad story (2). He tends to hide his upset. He had his first tooth at 3 months old. He always had a great fear of dogs and other animals (2).

Temperature:
He desires open windows in the car because he tends to have motion sickness. He tends to sweat almost every night on the head and back soon after falling asleep. He tends to sweat on the part laid on.

Sleep:
The first part of his sleep he tends to be quiet but he becomes restless in sleep around 1-2 a.m. He sleeps often with his arms above his head. He is often found in the middle of the night lying on his abdomen with his legs hanging off to the bed. He tends to grind his teeth or chew in sleep, which is worse when he changes position or if he is moved.

Appetite:
He has a poor appetite. He rarely has any appetite in the morning. He loves radishes (2) like his mother. He likes eggs (1), fried food (1), salt (1) and sour fruits like grapefruit (1). He tends to be thirstless.

Objective symptoms:
His face is white like alabaster. He has dark circles with puffiness under his eyes. He tends to lick his lips all the time. His lips are congested red. His veins are prominent on his chest. His feet tend to be sweaty and offensive, at which time he will develop athlete's foot. He has two warts under his foot and one on his finger. The urine has gross hematuria. On May 9, his alkaline phosphatase was 228 (N: 43-130), his lactate dehydrogenase was 251 (N: 107-228), his phosphorus was 5.0 (N: 2.4-4.8), his serum creatinine was 0.4 (N: 0.7-1.5), his hemoglobin was 10.9 (N: 13-17), his hematocrit was 32.6 (N: 33-49) and his eosinophils were 9 (N: 0-4). On July 17 his hemoglobin was down to 9.8, his hematocrit down to 29.4 and his red blood cells were down to 3.78 (N: 4.15-5.15).

Ass.: We had many symptoms but few very characteristic ones pointing to one remedy. No one remedy was most obvious. A case could have been made for Calcarea carbonica, Silica, Bryonia, Conium, Cantharis, Arsenicum album and Causticum. I decided to go with Calcarea carbonica due to the tendency to chew in sleep with the combination of sweating on the head every night. This is in spite of Calcarea carbonica not being known to be related to kidney inflammation.
Plan: Calc. 200 D.

Summary of the case from August 15 1997 until August 21, 2002:
He was given Calcarea carbonica 200 D and eventually 10 M several doses of each without any changes in the hematuria in spite of mild general improvement such as the perspiration and the grinding of teeth and chewing in sleep almost disappearing. On September 29, 1997 he was prescribed Silica 200 C during an acute asthma crisis to which he responded immediately. Again, in spite of being better with Silica, the hematuria was unchanged. For the nights of October 10 and 11 he woke around 3 a.m. with a cough followed by asthma. He responded only mildly to Silica. He was then given Arsenicum album 200 K. He responded only mildly to Arsenicum album. On October 12 and 13, he woke up around 4 a.m. with the cough. He was prescribed Kali carbonicum 200 C. The hematuria became much worse. The parents then described the urine as "pure blood."

After 36 hours of severe hematuria he was represcribed Calcarea carbonica 10 M as the grinding of teeth had also relapsed and was pronounced ("loud between each cough"). The grinding teeth stopped, the cough improved greatly and the hematuria settled down to the pre-aggravation level. He was kept on Calcarea carbonica 10 M until October 27. The hematuria was persisting. Now he would grind or chew mainly when he would change position in sleep. He was found often with his legs hanging off the bed. He wanted more salt. The perspiration at the beginning of sleep was returning. He was still licking his lips.

Ass.: With the aggravation from changing position, the sweating starting on first falling asleep and the desire for salt and to hang his legs off the bed all indicated Conium maculatum.
Plan: Conium 200 C.

The sweat and the chewing stopped but the licking got worse. The hematuria stayed unchanged. On November 3 he was prescribed Bryonia 200 C. The hematuria became much worse, "pure blood" again. He was sleeping more consistently with his arms above his head and the grinding of the teeth had relapsed. He was found constantly uncovered in sleep. He was then given Sulphur 10 M. The hematuria improved immediately.

Over the next five weeks he improved in general and for the first time the hematuria had slowly improved. As he had reached a plateau on December 15 he was prescribed Sulphur 50 M. He improved in general but the hematuria didn't improve further. His mother mentioned that he could eat anything that is fried these days. On January 12 he was given Plumbum metallicum 200 C. The hematuria improved at first. On February 1, he was prescribed Plumbum metallicum 10 M. There were no further changes. Later on he was prescribed Pulsatilla for an acute cold. He was eventually given Natrum sulphur without any reaction. In late March he developed a right sided sinusitis characterized with pain above the right eye which was ameliorated by pressure. He had a cough that was provoked with deep breathing. Lycopodium 200 C was prescribed without success.

On April 3, I studied the case anew. J.W. had improved in general following many remedies but the hematuria had persisted until now. Only under Sulphur did it improve but only to a limited degree. There was one symptom in particular that had been unchanged since the beginning, in spite of general improvement, which was the constant licking of the lips.

Ass.: It was late at night and while looking at the rubrics Face, Licking lips, I asked myself could this case be a Kali bichromicum case? I typed kidney on ReferenceWorks and looked at Kali bichromicum. I found an article in the Hahnemannian Monthly of 1894 by Dr. Pritchard entitled, "A Study of the Pathogenetic Action of Kali Bichromicum upon the Kidneys." In it I found that nephritis is a major symptom of Kali bichromicum and I now prescribe it with confidence as it also has the peculiar vesicles on the cornea.
Plan: Kali bichromicum 200 C.

Soon after taking it his sinus headache got worse. The next morning his urine was much clearer than usual. His mother remarked that his "spirit and energy were up." Also the parents noticed that his carsickness became better.

The remedy was repeated as needed depending especially on the hematuria. Within 3 weeks there was no more gross hematuria but we started to check his urine a few times a day with dipsticks for microscopic hematuria which continued to improve. By April 29, there were no more improvements in the microscopic hematuria. He was then prescribed one dose of Kali bichromicum 10 M. The next day he developed a stuffy nose followed by a fever, then a cough, then mild wheezing. He showed positive for strep infection. The hematuria got worse at first then got much better. On May 8, he developed a green discharge from the right nostril. Before repeating the remedy, we waited until there was no change for 7-10 days with the hematuria, or if the hematuria would relapse for three successive readings. As the hematuria had stabilized the remedy was repeated on June 1. His energy immediately picked up and he became livelier. His appetite increased. They let him have dairy without any noticeable reaction. The dark circles and the swelling under his eyes disappeared. The urine became clearer and in greater quantities. The two plantar warts started to look drier. The finger wart dropped off within a week of the remedy. He became more adventurous.

The remedy was again repeated on July 1. The urine would still be clear but the microscopic examination would now show only trace of blood. On July 13, he saw the nephrologist who declared J.W. "clinically cured." For the first time since the beginning of the treatment he started to lick his lips less. The plantar warts were gone by July 14. Now he would occasionally be negative for trace of blood.

Soon after, the urine became consistently negative and J.W. seemed to be in excellent health. He was well until December 10 when he developed a bad cold. Kali bichromicum 10 M was prescribed without any changes. Kali bichromicum 50 M was then prescribed. He did very well until he developed a fever with sore throat on January 26, 1999. For the first time since last August, he showed traces of blood in his urine. He tested positive for strep. He was represcribed a dose of Kali bichromicum 50 M. By the next day he was much better. He developed another strep throat on June 6. He was represcribed Kali bichromicum 50 M. He responded quickly to the remedy. On June 14 his nose was still congested. He was represcribed one dose of Kali bichromicum 50 M. I saw J.W. informally on August 17, 1999. He had a nice rosy complexion and his mother reported, "He is doing excellent." On March 28, 2000 I talked to the father inquiring about J.W.'s health. This is what he said: "He is doing excellent. Better than excellent. He is a perfect kid. He used to be weak and frail and would always get colds and stuff. It is really amazing. If he starts a cold he gets a 10 M of the remedy and it goes away immediately. Every time I see a doctor I tell him that my son had a clear case of IgA nephropathy pissing pure blood for months on end. They don't believe it. They don't want to believe it. His energy is perfect. He has had no more blood in the urine." Later that day his wife phoned and said: "It is a miracle. It is a miracle to homeopathy. I remember when I first called you and the other doctors told me there was nothing to do and I was crying on the phone not knowing how long he would live. Now I just look at him like a normal boy." J.W. got a dose of the remedy on the average every 2 or 3 months. I saw J. W. again on August 21, 2002 as he had had three occurrences of strep throat during the past year. As his parents where still using the 50 M potency with him I told them to increase it to CM. They had been afraid of "running out of potencies." Beside these episodes of strep to which he responded well to the remedy, he had been in very good health. He had a very nice complexion when he came to the office. His parents said that he used to be the weak and pale one of the family and that now he has high energy and never complains of being weak.

CONCLUSION:

This case is an excellent example of how perseverance leads to success. At almost each visit, the mother would ask whether her son was curable to which I would respond emphatically, "Of course, your son has an inflammatory disease and it is therefore curable with homeopathy." She would answer back, "But when are you going to find the curative remedy?" "I don't know, but I invite you to be patient and perseverant." This reminds me of one of Hahnemann's cases. A few month old girl developed crops of bluish boils in different parts of her body soon after vaccination. Under the care of the most eminent physicians of Vienna, the child grows worse, as deep abscesses develop in the soft tissue and bones. Fatal termination is now predicted for the infant. The father writes Hahnemann in Cöthen for help. "Hahnemann answered in the affirmative with the distinct addition that patience, perseverance, and the strictest obedience to the medical advice must be enjoined, and that successful treatment will require several years. After three years of treatment the father visits Hahnemann with his much-recovered child. After seven years she was fully recovered. At age twenty she married and became the mother of two healthy children. At age fifty she related this story to her treating physician.

Another interesting fact is that no one could have come to Kali bichromicum from the original case.

Epilogue:

I have presented five cases that show the unmistakable power of homeopathy in helping even the most moribund patient back to health. To obtain such results homeopathy must be practiced precisely as Hahnemann taught us. Can you imagine how much peace homeopathy would bring to suffering humanity if it was universally used?