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A New Look At Old Remedies David Wember, M.D., D.Ht. (March 92) Excerpted from a presentation given at the Ohio/Southern/Michigan/Pennsylvania Homeopathic Medical Societies' Meeting in Dayton, Ohio, October 1991. ABSTRACT: Several small and unusual remedies prescribed for various clinical conditions are hghlighted. Covered are such conditions as nausea of pregnancy, colds and allergic rhinnitis, external otitis, urinary incontinence, postnasal catarrh, proteinuria, pre-eclampsia, influenza, chronic fatigue syndrome, coughs, diabetic neuropathy, herpes zoster, and facial neuralgia. KEYWORDS: nausea of pregnancy, colds, allergic rhinnitis, external otitis, urinary incontinence, postnasal catarrh, proteinuria, pre-eclampsia, influenza, chronic fatigue syndrome, coughs, diabetic neuropathy, herpes zoster, facial neuralgia, Symphoricarpus racemosa, Amygdalus persica, Wyethia, Arundo, Kali suphuricum chromico, oil of mullein, Verbascum, Arum dracontium, Arum triphyllum, Kali chloratum, Ichthyotoxin, Antimonium suphuratum auratum, Calcarea carbonica, Sarcolactic acid, Phosphoricacid, Picric acid, Triosteum perfoliatum, Antimonium iodatum, Populus candicans, Gnaphalium, Zincum valerianum In preparation for a presentation I gave at the Ohio/Michigan/Pennsylvania and Southern Homeopathic Medical Societies' Meeting in 1990, I reviewed my clinical practice for a period of four months, paying special attention to smll and unusual remedies that I found especially useful. The following is a report of my observations. One of the problems that came up frequently was nausea, specifically nausea of pregnancy. A lot of women go through pregnancy just fine, but for some reason there is a propensity for having queasiness, nausea and vomiting. You can see the entire spectrum, ranging from sqeamishness to intractable violent vomiting. The remedies that come to mind most prominently are Ipecachuana, Nux vomica especially for morning sickness and Sepia. Two of our other great remedies are Colchicum and Cocculus; both possess a very characteristic symptom even the sight or smell of food excites nausea and vomiting. Many of these patients feel terrible during the first few months of pregnancy, and anything that we can do to help them will be appreciated. So, in addition to the indicated remedies, I advise some dietary changes: to always keep a little bit of food in the stomach (soda crackers are fine); hot vinegar tea, sweetened with honey; ginger tea; a little extra vitamin B6. There are two other remedies for nausea of pregnancy which you may or may not have come across. One is Symphoricarpus racemosa, the snowberry. It has been a very important remedy for me for nausea of pregnancy. Looking back at that remedy, in 1882 Dr. Moffit read a paper about it. He talked about Dr. Burdock who years before had investigated the snowberry because he was trying to discover remedies that had not yet been incorporated into the Homeopathic Pharmacopoeia. He said of the first prover, an intelligent lady, who on feeling the marked nausea which it soon produced, said, "Doctor, this is precisely like the morning sickness that I always experienced during pregnancy." That is how Symphoricarpus became an important remedy in morning sickness. Julian Winston said that in the Naturopathic library in Toronto there is a book with a letter from Kent in which he says that Symphoricarpus in a 10M potency is as much a specific for the nausea of pregnancy as any he has ever seen. Another remedy that I have found to be important in the nausea of pregnancy is Amygdalis persica. This remedy comes from peach bark. Now let me read something that comes from New, Old and Forgotten Remedies by Anschutz. He talks about a paper by Dr. Edson in Chicago in1890. "Some ten years ago I had a little patient whose principle difficulty seemed that he was unable to retain anything whatsoever upon his stomach. He would vomit up promptly everything that I gave him, and I had given him everything I had ever heard of and also had some eminient counsel, but it was no go. I was litterly at my ropes end. At this juncture an elderly neighbor, one of "the good old mothers," timidly suggested an infusion of peach bark. Interesting how we get some of our remedies. After some thought, I decided to find the bark ,which I was fortunate to procure after a long tramp through the country and two feet of snow. I prepared an infusion; the deed was done and presto the child was cured." He gives various instances of its usefulness. It is a very good remedy for nausea of pregnancy. These four remedies Colchicum, Cocculus, Symphoricarpus, and Amygdalis I keep on hand and prescribe often. This reminds me of a story. About five or six years ago a patient of mine called and asked if I could come over. She was terribly sick with nausea of pregnancy. In fact they had moved her from the country where she lived to her parents' house, near where I practiced, because she needed care. She had been to the regular doctor and was given injections and suppositories. Nothing was helping. She was desperate. I said I would come over after work. I took a vile of each of the following seven remedies: Ipecachuana, Nux vomica, Sepia, Colchicum, Tabacum, Amygdalis, and Symphoricarpus. I felt that one of those was going to work, but I wanted to speak to the patient first. When I got to the house, I was led downstairs to the recreation room. Everything had been removed, and she was there prostrate on a sleeper couch. I pulled up a chair next to the bed. She looked miserable. She had a pot next to her in which to vomit. I began talking to her, taking her case with the usual questions. I noticed she turned over to look at the other side of the bed and just started to wretch. Her mother was on the other side of the room talking to her. When she sat up to answer, she vomited again. What remedy do you think? Bryonia. Any movement she made caused her to vomit. So remember, you are always looking for the specific symptoms of the patient. I took out a vial of Bryonia and put a dose in water and told her to sip on it. She called the next morning and said she was already getting better. So, individualization of the case is imperative. With the onset of allergy season various remedies call for consideration. There is Allium cepa, the red onion, Arsenicum album, a very effective and deep-seated remedy, and Euphrasia, eyebright, which is of use when the eyes are red and irritated and the nasal discharge bland. If I had to pick one remedy for this condition, I would probably choose Sabadilla. It is a wonderful hay fever remedy. When there is a lot of itching, especially in the palate, Wyethia is a wonderful remedy. It is from the poison weed. Accompanying the itching are a sore, red, irritated pharynx and itching of the posterior nasopharynx. Another remedy that has the same deep-seated itching in the mouth, nose and ears, sometimes so intense as to drive the patient crazy, is Arundo, from the reed. I learned of this remedy when, years ago, a patient came in with allergy symptoms. In her history she described a peculiar symptom of pain in the stomach "as if there were something alive," similar to when she was pregnant. This symptom is not in Kent's Repertory, but it is in Boericke's "as if a fetus in the abdomen." Arundo had both of those symptoms, and it cured her allergies. Succinic acid has been helpful to me in the past. It is prepared from amber. It has all the symptoms of allergic rhinitis. I have helped people with that remedy. Another remedy is the alum of chrome, Kali sulphuricum chromico, which has sneezing, watery eyes, runny nose, and nasal itching. Recently I have found this remedy to be very useful in allergies. Once again I want to remind you that we are treating the patient; consequently we try to find a remedy to fit a patient's constitutional nature, the deeper remedy that seems to fit the nature of the case, but in doing so we must not ignore the specifics. A useful agent in my daily practice is Mullein,Verbascum. Oil of Mullein is a classical remedy for earaches. This oil can also be used for itchy scaliness in the ear canal exfoliative dermatitis in or around the ears, like Calcarea picrata, as well as after suppuration, like Calcarea sulphurica. Dr. Cushing wrote in 1884: "My father's house was the home for all poor tramps, as well as ministers, etc. One day he fell into the river and got water in his ears and was quite deaf for months. A blind man called, heard loud conversation, asked the cause, etc., then said that because of all the kindness he had recieved, he would tell us how to make something that would surely cure him. It was worth a thousand dollars in New York City. We made the oil of mullein, put it in his ears, and he was well in the morning." Interesting how these things come about. In one of Herring's books he talks about how it is an old German remedy to help ear conditions. Another tip that I have recently found to be helpful also comes from Dr. Cushing. Here is what he wrote: "For years we kept a bottle of it [Mullein] and traveled all around town, and it did wonders for people. When I studied medicine and I was praticing, I wanted to know if the mullein was homeopathic, and I made a proving. I developed the symptom of almost constant, but slight involuntary urination, keeping my pants wet." I have used it recently for enuresis. There are various remedies that we use for enuresis Causticum, Sepia, etc., various remedies that appear in the Repertory with which we have had some success in children. Mullein has this constant involuntary urination, constant dribbling. We sometimes get cases of children, more often little girls than boys, who wet their pants often during the day at school or daycare. It is not an easy thing to cure. The mullein in low potency homeopathic doses has helped several of those children whom I had not been able to help previously. So, you might keep this remedy in mind for daytime involuntary urination. I have not used it in adults yet. One other symptom of mullein is a teasing cough at bedtime. When the patient lies down at night and starts to cough, a dry, teasing cough that is hard to stop, mullein has proved helpful. I had an interesting case recently, a patient who came in with a two-year history of feeling as though he were going to choke. There was a constant drip in the back of his throat, in his larynx, that was always annoying him. He had been to half-a-dozen different allopathic doctors, including ENT specialists. He had sinus surgery in the hopes that it might help. One month later the symptoms returned. He had to clear the mucous out all the time. He was better talking, better eating, and worse swallowing. I gave him Lachesis initially. The sensation of his throat closing, worse from swallowing his own saliva and ameliorated by eating solids, spoke for that remedy. There was perhaps a10% improvement. The next remedy that I prescribed was Arum dracontium, not Arum triphyllum. This latter remedy has clergyman's sore thoat and lots of acrid discharge from the nose. In fact, it is my prime remedy when children have a dripping nose and there is redness and excoriation between the nose and upper lip. Whether the excoriation is the result of a dripping nose or a cold sore, use Arum triphyllum; it is a wonderful remedy for that characteristic. In contrast, Arum dracontium has a constant need to clear the throat, like Phosophorus, which is often useful for this symptom if other symptoms fit. Well, after Arum dracontium this patient improved considerably. There are various remedies for nasal and post-nasal discharges. For thick yellow discharges, Pulsatilla, Hepar sulphuris, Kali bichromicum, and Hydrastis have all been very helpful. I remember questioning a patient last year about his discharge, and he said it was white. Most patients mean clear when they say white. So I always ask ,"Do you mean like a cooked or uncooked egg white or milky white?" There are various color rubrics for discharges throughout the Repertory. For white discharges from the nose, Kali chloratum is in the highest degree. Natrum muriaticum, Kali muriaticum, Sepia and others all have white discharges, but think of Kali chloratum for white discharges in the respiratory tract. It is listed under white expectoration from the chest and is the only remedy under opaque white discharges. The first time I learned of Kali chloratum was from Dr. Rood. She talked about it in Toxemia of Pregnancy, where there is protein in the urine, and I have used it successfully several times in this situation. I have used this remedy several times for proteinuria in children. This is more frequent in boys than girls, especially after exercise, but there are a few that will have it all the time. It is not always pathological, but you do have to be careful. I routinely send these children to the urologist to make certain there is nothing wrong with the kidneys. Then a dose of Kali chloratum will often clear the protein. Another remedy that has helped me in this same respect is Ichthyotoxin, from eel surum. "Eel surum is to the kidney as Digitalis is to the heart" is a quote I recall which describes this remedy's relationship to the kidneys. When the kidney is affected primarily and there is protein in the urine, as in the nephrotic syndrome, think of Ichthyotoxin. Kali chloratum can also be used to advantage in this same way. Another remedy I have used recently that has helped patients with constant post nasal drip is Antimonium sulphuratum auratum, the golden sulphuret of antimony. Farrington talked about this in his Lesser Writings, and it has helped me. For chronic nasal obstruction, I find that somewhere along the line the patient will require a dose of Calcarea carbonica. Many of these patients cannot breathe when they lie down; they get hooked on nasal drops. Calcarea carbonica over time will help them. Sangunaria nitrica is another remedy for chronic nasal obstruction; it also has polyps in the nose. Calcarea carbonica is also a great nasal polyp remedy. Lemna minor and Sanguinaria come to mind for nasal obstruction and nasal polyps. Flu season is already upon us. The usual Gelsemium, Eupatorium perfoliatum, and Ocsillococcinum are quite helpful and find frequent use, but are, of course, insufficient to meet all cases of influenza. What remedy do you think Boericke is describing in the following passage? "Epidemic influenza, especially with violent retching and greatest prostration, when Arsenicum has failed. Tired feeling with muscular prostration, worse any exertion. Sore feeling all over, worse in afternoon. Restless at night. Difficulty getting to sleep. Tired feeling in the morning on getting up. Tired feeling in back and neck.extreme weakness.stiffness." It is Sarcolactic acid. It has fit many cases of influenza and has been very helpful, especially for the tiredness, muscle aches and soreness described above. More recently many people have come in for Chronic Fatique Syndrome. I have often found Phosphoric acid, Picric acid and Sarcolactic acid to be useful in helping relieve the overwhelming tiredness characteristic of this syndrome. For gastrointestinal influenzas there are several remedies, such as Cuprum, Cuprum arsenitum and Veratrum album. Triosteum perfoliatum is a remedy I have found helpful with the symptom complex of queasiness (a little stomach upset), muscular aches and frontal heachache. These cases display all kinds of mild flu symptoms, but they do not develop a full-blown acute flu. It has really been helpful for that mild kind of upset stomach and achiness. These symptoms need not always be associated with the flu for Triosteum to be of benefit. I have seen at least six cases now that it has helped. Here is an unusual cough remedy. I have used a remedy called Antimonium iodatum. We most often use the classical remedies for coughs Phosphorus, Bryonia, Antimonium tartaricum, etc. However, often, when the cold seems to descend straight down into the chest and is hard to get rid of, I use Antimonium iodatum. In my experience the cough is usually dry, the mucous seeming stuck in the airways. The iodide component seems to bring up the moisture from the lungs. It is a great expectorant, just as is the iodide allopathically. Here is an interesting case just recently in my office. The patient came with a third recurrence of the same symptom complex, the episodes recurring every two years. Each time a tremendous flu initiates the sequence. She feels achey, tired, and hoarse. Before she is very sick, she can hardly talk, with hoarseness, and she knows she is going to be bedridden for six weeks. She tried the antibiotics before without benefit. She still spent six weeks in bed. I found the remedy Populus candicans, the Balm of Gilead. Normally I would have thought of Causticum or Phosphorus, but neither remedy seemed well indicated. She took Populus and the hoarseness evaporated. All of her symptoms cleared after this remedy, and she has not relapsed since. Keep this in mind: cough with severe hoarseness (typically painless) Populus candicans. Can Homeopathy help chronic disease? Forgive the rhetorical question. I have a forty year-old patient who has had diabetes since childhood. She has had various complications, one of which was a diabetic neuropathy with numbness down the left lower extremity. Her doctors said it could not be helped. I thought of the sciatica remedies which have pain and numbness, and I gave her Gnaphalium. After six weeks it cured that problem; the feeling in her leg returned. Another case, an elderly lady, came with the complaint of post-herpetic neuralgia of two year's duration. The after-effects of shingles can cause terrible pain. The pain was over the left side of her head, face and eye. I gave her several remedies without help. ThenI used Zincum valerianum. It helped within a week. I gave her one dose because I only had a 1M potency, and she got better. Another patient came in who had both shingles and tic douloureux, with terrible, terrible pains. It was again on the left side, and Zincum valerianum helped her too. Whether it is just a left sided remedy I do not know. Zincum valerianum is a good remedy to keep in mind for severe neuralgic pain in the face. A patient called recently saying that he had a spasm in the stomach. "It closes off right here (pointing to the epigastrium)." "I can't eat, drink or do anything. If I do, it comes right back up. It is a terrible spasm. I just need to lie down for a while. Usually after an hour or so it goes away. I get it periodically. The spells came very close together recently." I made note of the location of the spasm the junction of the esophagus and the stomach, the cardiac end of the stomach. Well, why it came back to me I do not know, but I remember hearing at the NCIHH summer school of a remedy with cardiospasm. I told the patient that the next time experienced that spasm he should take. It is right there in Kent's Repertory under the "swallowing" rubric. It is Phosphorus. When he came for the next appointment, he said that he had another attack, used the Phosphorus immediately at the beginning of the attack, and his stomach immediately opened up. These are a few clinical observations from a few months of my practice. I hope they have been of interest. Small Remedies in Everyday Practice(Fall 1994) David Wember, MD, DhT ABSTRACT: Dr. Wember yet again presents us with many clinical pearls regarding the utility of smaller remedies for everyday clinical practice. KEYWORDS: acne, arthritis, asthma, chronic fatigue syndrome, cough, infantile colic, fibromyalgia, heel pain, knee, rheumatism, sciatica, sinusitis, synovitis. I would like to talk about remedies I have learned to use in the past several years. Most of these are small remedies which I have found quite useful in acute situations. Often specific rubrics have led me to these remedies. One of the special qualities of homeopathy, for me, is how a strange, rare, and peculiar symptom can make a difference in finding the correct remedy. Obviously, the practitioner must pay attention to the entire picture, yet these small differences allow us to experience the uniqueness in each patient. Let me begin by talking about several remedies I have used for ASTHMA. We all know how disruptive wheezing can be to someone's life. Sometimes it occurs only in a specific situation. A patient recently told me she cured her allergy to dust. She was in a health food store and told them she became asthmatic every time she dusted. The proprietor looked up his computer program and said that POTHOS FOETIDUS was the only remedy listed for that condition. She took the remedy and can now clean house without wheezing. We never stop learning from our patients. They are often our best teachers. Remember the keynotes of POTHOS: asthma relieved by stool; a red, butterfly-type rash across the bridge of the nose, like that in Lupus; and an overlooked symptom, severe tension and bloating in the abdomen, often described as 'hysterical tympanitis.' Another remedy involves an allergic sensitivity to horses. I have had several cases of asthma, related to horses that have been cured by CASTOR EQUI. This remedy comes from the rudimentary thumb-nail of the horse. I can think of one particular teenager who very much loved to ride, yet she was having great difficulty just being around her horse. She needed an inhaler every time she entered the barn. With this remedy, CASTOR EQUI, she was able to continue her riding without the need of drugs. Sometimes the sensitivity is due to the mold in the barn. For this, a remedy made from the specific barn mold can be quite helpful. I often see patients, especially young patients, with exertional asthma. As in other asthmatic conditions, it is always important to identify and eliminate the offending allergens; most often dust, mites, mold, foods, etc. In the past I talked about ICHTHYOTOXIN, eel serum, which is called the Digitalis of the kidneys. ASPIDOSPERMA, from quebracho, is called, by Hale, the Digitalis of the lungs. One of its main symptoms is exertional dyspnea, like LOBELIA INFLATA. I use it in the tincture. In congestion, the first thing I ask my patients to do is to stop eating dairy products. Hahnemann was not opposed to proper nutrition. The high molecular weight proteins, like casein and whey, are often allergenic and cause congestion. Some extra Vitamin C acts as an antihistamine. I use these as adjuncts to the remedies. If you did nothing else but stop dairy products, it is my opinion that 50% or more of these children would cease their recurrent congestion and even otitis media. When a dairy sensitive child is doing well and suddenly comes down with congestion, I question the mother carefully. Often the child has either gotten ice cream at a school birthday, or the father, who doesn't believe in this, sabotages the program, or the grandparents took care of the children for the day. It is difficult to change the habits and attitudes of grandparents. One of the remedies that has cough on lying down is STICTA PULMONARIA. It has a short, dry, hacking, incessant, annoying cough. It doesn't necessarily wake the child up. It wakes the parents up. They hate to hear the child coughing. A dose of STICTA makes very appreciative parents. Another cough remedy that I have used,in the past, is ARALIA RACEMOSA. It, too, has the cough on first lying down. But more specifically, it is aggravated after the first sleep. It keeps the parents awake. ARALIA also has asthmatic symptoms, and waking up with wheezing after the first sleep is a good indication for ARALIA. LACHESIS has cough and wheezing at night; the classic sleeping into the aggravation. It is usually later on at night, and the cough doesn't necessarily wake the person up. A sound-alike remedy, ARANEA DIADEMA, from the spider, has been very helpful in heel pain, pain in the os calcus, as from bone spurs. It is worse, especially on first motion. PULSATILLA and VALERIANA can also be considered in this condition. Patients also talk about a cough excited by tickling or irritation in the throat, which seems to be a generic term in this instance. One has to be more specific. Is it in the pharynx, larynx, trachea, bronchi, chest, etc. SENEGA has a very irritating, scraping sensation high up in the throat and fauces, and it is often used in elderly people with chronic coughs. Nash says it's useful in obstinate coughs of old people with difficult expectoration. It has a peculiar symptom of catarrh of the chest alternating with diarrhea which once led me to the cure of a case. I had a patient with a post-influenzal cough lasting two months. After using many remedies to no avail, I finally cleared the cough with CIMICIFUGA RACEMOSA. This remedy has a very dry, short, cough, with irritation from a dry spot in the larynx and marked aggravation from talking. Spasmodic coughs often yield to HYOSCYAMUS, when other remedies fail, as does frequent urination from bladder irritability. HYOSCYAMUS is similar in its nature to Belladonna, in being able to relieve the spasms of smooth muscle. Likewise, on an emotional plane, IGNATIA will cure the nervous cough of globus, a lump sensation in the throat. This reminds me of a special use of BELLADONNA in the spasm of circular smooth muscle, like bile ducts, where, as Kent says, in gall stone colic, it relaxes the muscles of the bile ducts allowing the stone to pass. Dewey says the same of DIOSCOREA VILLOSA. Remember the distinguishing symptom of DIOSCOREA, being better bending backwards, rather than doubling up as in most other colicky remedies. The patient will be forever grateful. CHOLESTEROLINUM has also been a powerful remedy for me in this regard. It is most frequent to have a cough that is loose in the morning and tight in the evening or at night. AMMONIUM MURIATICUM has the reverse modalities: dry in the morning and loose in the afternoon and/or evening. AMMONIUM MURIATICUM has several keynotes. One is coldness between the shoulder blades. The symptom I have used it for most frequently is sciatica, better only when lying down. It is similar to DIOSCOREA in this respect. Remember AESCULUS HIPPOCASTANUM for lumbosacral pain, especially when worse standing. Most coughs are worse lying on the left side. I believe there is a physiologic explanation for this. I had a patient who complained of a recurrent severe cough every fall, often progressing to pneumonia. His strongest modality was worse lying on the right. STANNUM METALLICUM cured the case. Remember the sweet tasting sputum of STANNUM which has helped me to find the right remedy in several cases. Most coughs are worse lying down. Try MANGANUM or MANGANUM PHOSPHORICA when better lying down. It also has the hoarseness, worse cold and damp like DULCAMARA, and better lying down. Coughs of gastric origin have been helped with SANGUINARIA, when the cough is better after eructations or passing flatus. VERATRUM ALBUM, from the white hellebore, has a cough coming from deep in the abdomen, better eructations, or with concomitant diarrhea. It is similar to SENEGA in its chest symptoms, with lots of mucus in the bronchial tree and difficult expectoration. It is also one of the few remedies worse in a warm room or on entering a warm room from the cold, like BRYONIA. I remember Dr. Rood discussing VERATRUM VIRIDE, from the white American hellebore. It has rapidly progressing lung congestion, dyspnea, heaviness of the chest, livid and bloated fauces, and drop in blood pressure. I suggest thinking about it for ADULT RESPIRATORY DISTRESS SYNDROME. Remember CASTANEA VESCA for its short, tight, 'ringing', cough; COCCUS CACTI for its spasmodic cough, better in the cold air; CORRALIUM RUBRUM for its continuous "minute gun" type cough during the daytime and whooping-type cough at night. CORRALIUM has a profuse postnasal drip which is a good keynote for this remedy. Recently, a patient of mine had bronchitis. She told me she felt as if there were a long, thick string of mucus hanging down the back of her throat. CORRALIUM, saved the day. STICTA is similar in this regard. ANTIMONIUM SULPHURICUM and LEMNA MINOR also should be considered in postnasal drip. NAPHTHALIUM is another hay fever remedy that is efficacious in long-continued paroxysms of cough, worse at night, with tenacious mucus, and inability to catch the breath, worse inspiration, like BROMIUM, MANGANUM, and RUMEX. MEPHITIS has severe, suffocative coughing spasms at night, with contraction of the glottis, worse expiration. Cough "'till blue in the face" is Boericke's description of MEPHITIS. I always ask my rheumatic patients to refrain from eating the nightshade family of foods: tomatoes, white potatoes, green peppers, and eggplant. These foods have been associated with arthralgic pains, and I have found this to be true. SOLANUM LYCOPERSICUM, from the tomato, has many arthritic-type symptoms in it. I have successfully used it in right-sided pains, like STICTA. Kent lists it for parasthesias in the ulnar distribution, the inside of the arm and forearm. STICTA is listed for "housemaids knee." It is useful for chronic synovitis of the knee, like CALCAREA FLUORICA, and can be helpful for rheumatism of the small joints, like VIOLA ODORATA and CAULOPHYLLUM. A patient of mine once took CAULOPHYLLUM, herbally, to abort. She developed severe knee pains while taking the remedy, which persisted for a long time thereafter. Add CAULOPHYLLUM to the rubric: knee pain. It has helped me in several other cases. For chronic knee pain try NIACINAMIDE, vitamin B3. I don't know the physiology behind it. Jonathan Wright suggested it at one of his nutritional seminars, and it works. In fibromyalgia-type symptoms, remember RHAMNUS CALIFORNICA and CASCARA SAGRADA, especially when associated with constipation. In a speech I gave several years ago in Ohio, I talked of SARCOLACTIC ACID as an acute flu remedy. I suggest you also consider it for chronic fatigue syndrome, the type in which there is recurrent sore throat, with achy, flu-type symptoms and malaise. I also talked of FORMIC ACID for chronic arthritis. Consider, too, LACTIC ACID, in the differential for chronic arthritis. I had a patient with a long history of rheumatoid arthritis. She had been on Plaquenil for the past ten years, plus many anti-inflammatants. It had always flared in the winter for which she was given steroids. The most significant part of her past history was recurrent Strep infections throughout childhood. I gave her homeopathic STREPTOCOCCINUM 10M, one dose. She was about thirty percent better from that single dose, despite the heavy allopathic medications. She did not need steroids that winter. I remember a homeopathic doctor in Michigan who was very successful in treating arthritis with homeopathic bacterial nosodes. Recent literature has shown positive identification of bacteria and viruses in the synovial tissue of arthritic joints. If we could identify this early in the disease, what benefit might we bring to mankind. I am indebted to a patient for helping me find a remedy that I now use more frequently in my practice. She was a thirty-five year-old woman who came to me for chronic acne since her teenage years. She worked in a veterinary clinic and said that sometimes she went home and her urine smelled like cat urine. Now maybe that is not unusual for someone who works in that occupation, but on checking the repertory it led me to VIOLA TRICOLOR. This remedy is quite useful for acne and impetigo-like lesions about the face, especially in children. When chronic or recurrent pustular-type lesions do not respond to the seemingly correct remedies, try a dose of ARSENICUM ALBUM. It has been my 'sheet-anchor' in this circumstance. Anyone who has had children knows the agony of the COLICKY baby. I have oft quoted the old-time statement that "Homeopathy can rest its laurels alone on ARNICA." Second-best might well be CHAMOMILLA. To lower the pain threshold in any illness, notwithstanding the colicky child, is surely a blessing. CHAMOMILLA has made millions of grateful patients. But alas, when it doesn't work, how can we individualize for the correct remedy? Certainly we can use COLOCYNTH or MAGNESIUM PHOSPHORICA, with flatulent colic, when the knees are pulled up and better with pressure and/or heat on the abdomen. STANNUM METALLICUM saved me once, when other remedies failed. It has that strong symptom of better with hard pressure on the abdomen, especially better walking with the child on your shoulder, so as to put pressure on the child's abdomen. ILLICIUM, from anise, has a wonderful track record for baby colic. Or use DIOSCOREA, when the child is worse bending double and is better arching backwards. I remember DIOSCOREA curing a case of kidney stone colic with the two strong symptoms being pain in the kidney region radiating to the testicles and better bending backwards. Have you ever noticed that colic is usually worse in the evening, just as the father comes home from work? What remedy has child good all day and troublesome all night? If you said JALAPA, then you have probably helped many a colicky baby and frustrated parent. SINUSITIS seems to be increasing in recent years. It is now thought to be the culprit for asthma and even chronic fatigue syndrome. Two main remedies are KALI IODATUM and ARSENICUM IODATUM, especially when there are thick, acrid nasal discharges. ARSENICUM IODATUM has more glandular involvement and night sweats. KALI IODATUM has more acrid discharges and pain at the root of the nose, pulsating or lancinating in nature, extending to the frontal sinuses. STICTA has dull pressure in the forehead and fullness at the root of the nose, with dry nasal passages. Boericke says COCHLEARIA, from the horseradish, has pressing and boring pains in the forehead "as if the frontal bone would fall out." CINNABARIS, from mercuric sulphide, has pressing pain above the root of the nose and shooting pains in the bones of the orbit "running from the inner to the outer canthus. Several years ago a patient of mine called to say that for the past week he had been experiencing chest discomfort while mowing the lawn. He was a pleasant, mild-mannered, mostly sedentary sixty-six year-old male. I immediately sent him to a cardiologist. Two days later he was recuperating from triple bypass surgery. He has continued to do well. Last spring, he called to ask me to send him another bottle of his allergy medicine. I told him, frankly, that I hadn't remembered him having allergies. He reminded me of the severe sneezing spells he would have every spring and fall, until he started using the granules I gave him. I told him I would look it up and send him some more. To my surprise, the remedy was BOVISTA. This prescription was based on the symptom, "nose obstructed, with watery nasal discharge, only from the left side." He had neglected to mention his allergies in recent visits, since he experienced no troubles while using the remedy. Last month, I treated a woman for acute sinusitis. Her symptoms were: pain in the left frontal and maxillary sinuses, with obstruction of the left nose with fluent discharge at the same time. I gave her BOVISTA and awaited her call. The next day she told my secretary the pain was all relieved. I thank you for allowing me to share my homeopathic experiences with you. Most of you share the joy and fascination of being able to help people with infinitesimal Homeopathic doses. I often hear excuses that remedies were antidoted by this or that, or that the pharmacy batch was no good to begin with. I quote you Shakespeare, "The fault, dear Brutus, is not in the stars, but in ourselves that we are underlings." Find the correct rubrics and the remedy will cure. My Favorite Little Known Remedies David Wember, MD, DHt (Fall 1995 JAIH) A Presentation Given at the Annual Conference of the National Center for Homeopathy, Baltimore, MD, April 1995 ABSTRACT: Dr. Wember regales us yet again with a fascinating pot pourri of small remedies and some of their indications. KEYWORDS: Thiosinaminum, Lac defloratum, Terebinthina, Teucrium marum, Petroleum, Sarsaparilla, Manganum, Senecio aureus, Graphites, Oleander, Tellurium, Formica rufa, Cinnabaris, Sambucus, Mephitis, Chlorum, Chloralum, Antipyrine, Bismuth, Dioscorea, Sinapis nigra, Anthracinum, Cement, Crataegus, Adonis vernalis, Convallaria majalis, Magnolia grandiflora, Calcarea sulphurica, Ferrum phosphoricum, cicatrices, migraine, nausea of pregnancy, aphthae and gastrointestinal symptoms; nasal polyps, nasal itching, rectal itching, tinea cruris, recurrent herpes genitalis, snuffles, sinusitis, dysuria, cough, spasm of glottis, eczema, psoriasis, herpes zoster, amenorrhea, menopause, tinea corporis, psoriatic arthritis, asthma, urticaria, gastralgia, abdominal pain, hiatal hernia, pyoderma gangrenosum, abrasions, cardiac cases, otitis Over the years I have reported on various small remedies that have been very useful to my patients. I usually don't go about looking for new remedies, But in everyday practice, as one peruses the repertory and materiae medicae while studying a case, one can't help but scan across many facts and remedies that one has never come across before. It is these tidbits that catch my eye, that inspire my further investigation. When thinking about remedies to present for this paper, my first thought kept coming back to Thiosinaminum, from the Oil of Mustard seed. Time after time it has helped women with abdominal adhesions either from prior pelvic inflammatory disease, endometriosis, or abdominal or pelvic surgery, including laparoscopic surgery. It is said to dissolve scar tissue. I find it to have an anti-inflammatory action as well. I say this because patients seem to respond so quickly, before any significant cicatrical absorption reasonably could take place. D.S., a thirty year-old single woman, came to me for recurrent upper respiratory infections and acne scars on her back. She also related having several days of severe right lower quadrant pains around the mid-cycle. I gave her Thiosinaminum in hopes of resorbing the acne scars. It didn't. But the mid-cycle pains almost fully disappeared, only to recur when she discontinued the remedy and disappear again on resuming the Thiosinaminum. She also has been healthier in general without the recurrent upper respiratory infections she used to get every winter, and there have been no further recurrent aphthae she was so prone to in the past. C.S., a thirty-two year-old married woman, came in with a four year history of abdominal pains "from ovulation to after the first few days of the flow." She had a prior history of uterine infection and two Caesarean sections. In 1991, a laparoscopy was performed for suspected endometriosis. She was diagnosed as having scar tissue, especially around the rectum, which may have been responsible for her constipation and knife-like pains in the rectum prior to stool. She was put on a trial of Thiosinaminum D3 twice daily for a month and then just at bedtime. Three weeks ago she reported what she called her 'PMS' symptoms as "great" . no further abdominal pains. R.G., a thirty-six year-old married woman, came to see me for a myriad of symptoms, the most striking keynote symptom being burning in the urethra when not urinating. The pain was worse lying in bed, and, in fact, often woke her up at night. Mercurius vivus promptly cured this. She also complained of lower abdominal or pelvic pains, mid cycle and during the menses, worse during stool. She had had endometriosis and laparoscopic surgery in the past. Only Thiosinaminum takes away these pains. They recur periodically. In the past I have reported about my favorite remedies for nausea and vomiting of pregnancy; i.e., Symphorocarpus racemosa, Amygdalus persica, Pilocarpus, Cocculus, and Colchicum, among others. Last July I saw a woman who was nine weeks pregnant with a history of nausea during her first two pregnancies and the present one. She was helping herself with Colchicum D6 (worse from the smell of food). Her main complaint was migraine headaches, worse during pregnancy. She was already being treated with Phenergan suppositories by her obstetrician. The headaches would build up all day long with vomiting in the evening, afterwards feeling some better. I considered Sanguinaria and Iris, since the migraines were preceded by a visual aura. The combination of the following symptoms lead to only one remedy: migraine with visual aura, one-sided throbbing frontal headaches, sick headaches, nausea of pregnancy, motion sickness, constipation . Lac defloratum. Allen calls it the ".American sick headache". Two weeks later the nausea was forty percent better and she had had only two migraines, and they were less severe. She told me that she no longer liked sweets. I asked her why? She said "sweets leave an after taste". Sanguinaria wrapped up the case. (Kent, p. 423: "bitter, sweet things taste: Rheum, sang.") Six months later she returned saying the rest of the pregnancy was uneventful. She was now concerned about going into labor. The previous two labors ended with Caesarean sections due to non-progressive labor. Over the next two weeks, using Caulophyllum and Pulsatilla, her water finally broke at 6 am of the morning she was going into the hospital to be induced. In the hospital, during labor, her husband called saying the migraine had suddenly recurred. Another dose of Lac defloratum once again came to the rescue, and mother and child are both doing well. Here is a one remedy rubric that has helped me in several cases: Kent, p.397, "Aphthae, extending through intestinal tract: terebinthina." A thirty-five year-old woman came to see me for chronic sinusitis and allergies. She was sick from fall through spring. I was able to keep her off antibiotics and decongestants. However, she continued to get periodic epigastric pain and acidity ever since an ulcer was diagnosed in 1986. I was able to palliate these symptoms with Bis Sub Nit. It was only after she associated the acidity with canker sores and stomatitis that I gave her Terebinthina and thereafter the gastrointestinal symptoms disappeared. A thirty-three year-old male came in for the following problems: Cough, twice yearly, lasting one month and needing antibiotics; loose stools with flatulence both up and down; anus sore with burning, itching and tearing sensation inside the rectum with stool; recurrent canker sores related to the anal burning. He was given one dose of Terebinthina 200C. Two months later he returned saying, "From my mouth right through my body I feel better." He had no further canker sores and seventy-five per cent less rectal burning and flatulence. This reminds me of another remedy, Teucrium marum (Cat Thyme), which has symptoms on both ends of the body, this time concentrating on the rectum and the nose. Like Cina, it reportedly is a great "worm" remedy. There is itching and rubbing of the nose, but it goes much deeper in its pathology. The nose is stopped up, often from polyps, where it has been extremely efficacious. I have used it for sinus conditions where the nose is completely stopped, yet discharging thick "clinkers." In sinus congestion I have my patients use a salt water and baking soda nasal lavage. If there are nasal polyps, I add three or four Teucrium D3 triturate tablets to the nasal wash. Teucrium has itching of the rectum, worse at night from warmth of the bed and after stool. Petroleum has similar symptoms. Petroleum is one of my main remedies in "jock itch" and recurrent genital herpes. I had a forty-two year-old male patient with a seventeen year history of chronic prostatitis. All allopathic treatments including several urethral stricture operations still left him with constant prostate discomfort, burning "hot spots" in the urethra on urination and ejaculation, severe intertrigo, and a red, irritative rash on the glans. He only felt better while on Cipro. The symptoms would return shortly after stopping the antibiotic. Petroleum in high potency would give only short term relief. I put the patient on Petroleum D6 twice daily. His symptoms have been very relieved. A remedy with similar urinary and skin symptoms is Sarsaparilla (Smilax). It has eczematous conditions, cracked skin, especially of the hands and feet, intertrigo and herpetic eruptions. It is said to be worse in the summer, whereas Petroleum is worse in the winter. A keynote symptom is painful urination very much worse at the close of urination. The last few drops are unbearable. The child screams before and while urinating, like Rhus aromatica. A symptom of Sarsaparilla that has helped me several times is: increased frequency of urination in the cold air. Speaking of the skin, psoriasis is a deep-seated illness that is difficult to treat both allopathically and homeopathically. Here is a remedy that has recently caught my attention . Manganum aceticum. I have used this remedy in the past mainly for the keynote symptom of cough, better lying. I use the phosphate of Manganum, in this instance, something I learned from Dr. Rood when she taught us years ago. The skin symptoms of Manganum are definitely not well repertorized in Kent: Chronic eczema and psoriasis especially about the joints. Cracked skin and suppurations that are difficult to heal. Deep-seated pains in the bones, worse night. Shin pains: very sensitive to touch. Ankles which get sore without explanation. Migrating and diagonal symptoms or crosswise pains Classic symptoms of Parkinson's Disease. It is listed in Kent in the third degree under the Menopause rubric. So, when I saw a woman, in her late forties, who was under extreme marital stress, who went into sudden menopause and at the same time developed psoriasis about the elbows and knees, I gave Manganum 200C. The psoriasis disappeared in two weeks. She's still under stress, but mentally, she said she felt more positive and better able to cope with her situation. Remember Manganum has anemia and has been reported to bring back the menstrual flow. The association of anemia, scanty menstruation, amenorrhea or flow between the menses and eczema are prime indications of Manganum. That reminds me of another remedy to bring back the flow, Senecio aureus. I remember Dr. Fred Schmidt telling us of its efficacy in amenorrhea after discontinuing birth control pills. Three major symptoms of Senecio are: 1. Amenorrhea 2. Sore throat prior to menses 3. Bladder irritability prior to menses. Graphites too has similar skin symptoms and is worse at the menopause. Other similar smaller remedies that could be considered in eczematous and psoriatic conditions are Oleander and Tellurium. Oleander has eruptions at the margin of the hair, especially on the occiput, and behind the ears. It is often associated with chronic diarrhea and involuntary stools when passing gas. I once had a case of Herpes zoster in a sixty-seven year-old woman who went on to a speedy recovery using Oleander. She presented with crusted over lesions on the left side of the head, running from the temple, behind the ear, to the occiput. What is so nice about Homeopathy is that it stimulates the healing from within so that it avoids Post-Herpetic Neuralgia. I have never had a case of Shingles treated homeopathically that went on to chronic Post-Herpetic Neuralgia. In fact, I have reported in past articles of curing cases of Post-Herpetic Neuralgia using homeopathy. I am sure that other homeopathic practitioners have had the same gratifying results. Tellurium is usually thought of in ringworm-type lesions, whether of herpetic, fungal or eczematous nature. It comes in circular patches. It also has the same oozing eczema behind the ears and on the back of the head. There is a kind of psoriasis that erupts in circular patches over any part of the body. Try Tellurium if other polycrests fail. I had a case of psoriatic arthritis which had great palliation with Formica rufa, two major areas of this remedy being arthritic and eczematous-type lesions. One Mercury that deserves more attention is Cinnabaris (Mercuric Sulfide). Clark says "redness predominates (color of the drug)." Very "fiery looking ulcers" anywhere in the body. I have used it most successfully in sinusitis. It has a dull pressive pain at the root of the nose with thick post-nasal discharge. In acute sinusitis the face can be red, swollen and very sensitive to touch. Dr. Hubbard gives just such a case, with cervical neck pain worse bending head backwards, cured with one dose of Cinnabaris 1M. A keynote symptom is pain in the inner canthus extending across the eyebrow to the outer canthus. Being a syphilitic remedy, it has cured many genital symptoms, including warts, and particularly any red swellings and rashes in the genital region, especially on the penis. Allergies are a huge problem in our society. Here in the Washington, DC-Baltimore area, it seems to be endemic. Homeopathically it is very deep-seated. The best treatment is constitutional prescribing. However, I find this often takes time. Meanwhile the patient suffers with allergic rhinnitis or asthmatic symptoms. I want to comment about the recent studies by Dr. David Taylor Reilly on the homeopathic treatment of allergies and asthma. I really feel for the allopaths. Trying to believe an infinitesimal dose of anything can actually do anything takes a leap of faith. Faith is a not the usual prescription in medicine, nor in our society in general. However, unless Randy the magician again conjures up some of his voodoo, the statistics of these studies should humble even the homeopaths. For many years, in my practice I have used "spring," "tree," "grass," etc. remedies (isodes of prevailing allergens) to successfully help seasonal allergies. They work! I'm glad Dr. Reilly has corroborated my experience. In the past I have used Sambucus nigra mainly for the keynote symptom of "Snuffles of infants." I have recently learned to make more broad use of this remedy. Allen talks of the "suffocative feeling" as a primary indication for Sambucus. That suffocative cough that wakes children up at night around or after midnight will often yield to Sambucus, if Spongia has not already done its job. Or like Mephitis (Skunk), the child sits up, blue in the face, with cough. Like Chlorum (Chlorine gas in water), it has a special affinity in spasms of the glottis. Epiglotitis might also be a prime indication. Sambucus, Mephitis and Chlorum all are worse expiration. Sambucus has a keynote symptom of perspiration on first waking in the morning, or only while awake. The perspiration disappears on falling asleep. Don't mix up Chlorum with Chloralum. Chloralum (Chloral hydrate) has asthma and respiratory distress with the sensation of constriction of the chest, but I use it mainly for urticaria, especially worse from alcoholic drinks and exposure to cold. I cured a case with alternating respiratory and hives symptoms with Chloralum. You might consider adding Chloralum to the alternating rubrics in the respiratory and skin sections of Kent. Antipyrine (Coal tar derivative) has helped me in several cases of urticaria with large red patches. It tends to come and go frequently and is especially applicable in erythema multiforme. The allopaths have recently lauded themselves for a new discovery. After all these years, peptic ulcers have finally been associated with a bacteria in the stomach, Helicobacter pylori. The "cure" being a triple "whammy" - two or three antibiotics and Pepto-Bismol, all taken simultaneously. Here is a quote from Pierce, which to me epitomizes, more than anything else, the difference between Allopathy and Homeopathy: ".allopaths brag about how much they can give without poisoning the patient, while homeopaths boast as to how little they can give and effect a cure." Bismuth subnitrate has been around since Hahnemann first prepared it, but it has not been given its due homeopathically. I first encountered Bismuth in a homeopathic OTC preparation labeled for "Nausea of Pregnancy." This preparation included Cerium oxalicum and Ingluvin, both remedies worth studying, but that can be a topic for another paper. Actually my first recollection of Bismuth brings me back to childhood where two preparations stand indelibly in my mind . Vicks Vaporub and Pepto-Bismol: Vicks in the nostrils and rubbed on the chest for any respiratory problems, and Pepto-Bismol for any gastrointestinal problems. Boericke says its chief action is for "irritation and inflammation of the alimentary canal.," and so it is. Gastralgia typifies this remedy. There is a burning pain or pressure as from a lump or a load in the stomach. The pain often extends backwards towards the spine. The gastralgia can be associated with neuralgic-type headaches, especially about the face, better vomiting or alternating with neuralgia. Bismuth is better from cold drinks and, like Phosphorus, often vomits after drinking or when the stomach gets full. A good keynote symptom is pain in the stomach, better bending backwards. Here it rivals Dioscorea in this modality. But whereas Dioscorea centers its flatulent colic in the abdomen around the umbilicus and the right hypochondria like Chelidonium, Bismuth centers its action in the cardiac end of the stomach, where it is found in the cardialgia rubrics. Condurango, too, centers its action at the cardiac end of the stomach. In Boericke's Repertory, under the rubric "Cardiac Orifice," there is a sub rubric of "Dilatation." I take this to cover gastroesophageal reflux and hiatal hernia symptoms. Last year a woman came in to see me with a multitude of symptoms. Among the most distressing was the dyspepsia from a chronic hiatal hernia. She had severe burning pain in the epigastrium, worse bending over, being treated with Zantac. I started her on Bismuth sub nitrate 3x. She came back two months later. She was very appreciative. "I can now bend over to do my housework and gardening without that terrible burning in my chest." In my last paper I briefly mentioned Hydrastin muriaticum in similar conditions. I have not had the opportunity to further check this out. I think this deserves more attention. Lecithin, in physiologic doses, is helpful in tightening up the cardiac sphincter. Bismuth also has perspiration, daytime only, like Sambucus. This reminds me of Sinapis nigra. This remedy, which is most applicable in upper respiratory infections and hay fever, has three peculiar symptoms that have helped me with several cases: 1. Abdominal pains, better bending backwards 2. Cough, better lying down 3. Sneezing, worse at night. In the past two years I have had two cases of pyoderma gangrenosum. There are two reasons I bring this up. First, this is a deep-seated internal malady presenting on the skin. It is important not to be suppressed. It is usually an extra-intestinal manifestation of inflammatory bowel disease, but in the present case it occurred in a forty year-old woman with chronic arthritis. Interestingly enough, the lesions only began after she started gold treatments. I saw her in June,1994. Two years earlier she had a boil on the right calf which enlarged to a golf ball size and finally opened, leaving a large crater which refused to heal. Even in the hands of a dermatologist, treatment with antibiotics and cortisone injections were of no avail. The ulcer was sensitive to touch, but not excessively. Because of the history of it being a boil that burst, I gave one dose of Hepar sulph 200C. In addition, I asked her to mix the following in four ounces of water: one tablespoon Betadyne one tablespoon sugar one-half tablespoon calendula tincture. I asked her to wash the wound with this solution twice daily. She returned five weeks later. The ulcer was sixty percent closed and half as deep. However, a small satellite ulcer had developed about an inch from the original. This had happened several times in the past. Because of the satellite lesion and the burning pains she felt while cleaning out the sloughing tissue each night, I gave one dose of Anthracinum 200C. Five weeks later there was only a pinhole size opening remaining in the satellite lesion. The main ulcer had healed. The second reason I brought this up was to comment on two other remedies that have been helpful in dealing with infections. Clark talks of Gun Powder as a powerful agent for sepsis, especially in wound infections. Dr. Boysen praised it highly and used it effectively during the war where there are many stories of miraculous wound healings. Clark also says it has helped Herpes zoster of the right trigeminal area. Here is a remedy that I have had personal use of. Has anyone had the experience of falling and scraping themselves on a cement surface? The abrasion seems to fester and take an indomitable time to heal. Years ago I came across Cement as a remedy. It was suggested for an irritative rash in cement workers. I potentized it myself to a 12x and have used it on the basis of similars for healing abrasions, especially when having fallen on cement. Try it. It works. Crataegus is our great heart tonic. Two other remedies with similar action deserve our attention: Adonis vernalis (Pheasant's Eye) and Convallaria majalis (Lilly of the Valley). Adonis has been helpful in strengthening a heart that has been weakened by valvular lesions. There is a weak, rapid pulse accompanied by oliguria, pulmonary edema, and peripheral edema. Convallaria has rapid and irregular pulse, fluid retention; marked dyspnea, worse walking; and inability to lie down. Nash talks of using it successfully in heart pain and "dropsy" when accompanied with uterine soreness. It is similar to Lillium tigrinum in this respect. It has the peculiar symptom of a sensation as if the heart had ceased to beat. This leads me to the remedy Magnolia grandiflora, which has the same sensation as if the heart had ceased to beat. It has angina and dyspnea, worse walking fast and when lying on the left side, and which is often accompanied by rheumatic symptoms: shifting articular pains and stiffness, worse dampness and first motion, like Rhus toxicodendron and Dulcamara. Finally, I would like to comment on otitis. There have been many good books and articles published recently that have been helpful in discerning the proper remedy selection. I am indebted to Dr. Richard Moskowitz for reminding us in his speech last spring at the American Instituteof Homeopathy meetings of the efficacy of Calcarea sulphurica in recurrent otitis media. I use it in the 200C or 1M potency. It tends to stop the recurrences while one works, over time, on more constitutional remedies. Lastly, in acute otalgia, I use a Ferrum phosphoricum DMM potency. This was taught to me by Dr. Panos when I was her student. I believe the original source is Dr. Boger. In my experience, no single remedy has been more effective in relieving ear pain than this one. The Heart and Soul of Homeopathy David Wember, M.D., D.Ht. (Spring 97 JAIH) This is the text of a presentation given at the Ohio, Pennsylvania, and Southern Homeopathic Medical Societies' Annual Meeting in Akron, Ohio, October 1996 Abstract: Dr. Wember provides examples of the deeply curative effects of homeopathic medicine, results which both gratify and constitute the "heart and soul of homeopathy." Additionally, several smaller homeopathic medicines and their corresponding clinical indications are discussed. Keywords: diarrhea, fibromyalgia, abdominal pains, skin conditions, psoriasis, ringworm, mononucleosis, asthma, COPD, sciatica, Sulphur, Natrum sulphuricum, Croton tiglium, Momordica charanta, Elaterium, Rhamnus california, Rhamnus purshiana, Nuphar luteum, Mercurius corrosivus, Gambogia, Phosphorus, Trombidium, Momordica balsama, Jatropha, Belladonna, Bryonia, Gelsemium, Ginseng, Lachesis, Hydrocotyle, Tellurium, Bacillinum, Iris versicolor, Grindelia, Kali arsenicosum, Senega, Rumex, Chrysophanic acid, Cistus canadensis, Aconitum lycotonin, Lapis alba, Grindelia, Mephitis, Chlorum, Sambucus, Aralia racemosa, Sticta pulmonaria, Antimonium arsenicosum, Squilla maritima, Colocynthis, Phytolacca, Aesculus hippocampus, Rhus toxicodendron, Calcarea phosphorica, Ammonium muriaticum, Staphysagria, Natrum sulphuricum Thank you for inviting me to speak today. Except for last year, I have been coming to the fall Ohio meetings for the past twenty-one years. Originally, when I was a student of Dr. Panos', the meetings were held in Cincinnati, with the likes of Drs. Dixon, Goldberg, Rood, Junkerman, and Dr. Panos. It was a smaller, more inbred meeting, but we learned many pearls from these masters, and I hope, over time, we have been able to pass some of this knowledge on to you. Akron, may be on the opposite end of the state, but it is still Ohio, and you folks know how to put on a great meeting. I have practiced homeopathy for the past twenty-two years, and it never ceases to amaze me, the power of the minimal dose. At the same time, I'm often frustrated, knowing the right remedy picture will help solve a difficult case and sometimes not being able to find the right combination of clues to fit together the puzzle to attain a cure or significantly help a case. In the past I have delivered many presentations, often concentrating on the peculiar aspects of small remedies and how they helped patients in specific circumstances. I have tried to bring more repertory and materia medica into play so as to broaden the choices we have in determining the remedies for each case. It has been fun and a joy to experience these remedies and pass them on to you. My biggest critic is my wife, Lissa. She's involved in helping me structure the papers and type them. She frequently asks me, "Why not talk about the deeper aspects of the remedies and how they affect the nature of the person." So this morning I will attempt to do both . give some more experiences with smaller remedies and discuss the deeper aspects of homeopathy which I call, "The Heart and Soul of Homeopathy." Irritable bowel syndrome is endemic in our society. There are many reasons, the first of which is stress. Job security and family structure are being eroded. Two income families have less spending potential today than single incomes in the past. I don't envy the young people just entering the job market. Better goal setting, stress reduction, meditation, and exercise are imperative prescriptions for our present generation. More and more food allergies are being implicated in intestinal problems. These have to be ruled out . dairy, wheat, gluten, etc. Sometimes isodes of the offending allergens can be very beneficial. Irritable bowel syndrome is a functional disorder with varied distressing symptoms. Flatulence, cramping, diarrhea and constipation predominate, in various combinations and severity. Morning urging and diarrhea are the most classical symptoms. When the patient is woken out of sleep, early, at five to six a.m., or on awakening is rushed to stool with urging and cramping, then Sulphur is a "Godsend," or Natrum sulphuricum, with its morning aggravation, sensitive-to-touch abdomen, flatulence and very large stools. Forceful or explosive stools aggravated by any food or drink indicate Croton tiglium. A similar remedy with yellow, watery, crampy, explosive stools is Momordica charanta, the Hairy Momordica. Elaterium, the squirting cucumber, which is also in the Momordica family, has forceful watery stools, along with a rheumatic diathesis. Remember Rhamnus california, the California coffee tree, in rheumatic diathesis and fibromyalgia type symptoms, but this is associated with constipation. Even more so, the Rhamnus purshiana, cascara sagrada, has fibromyalgia and constipation. A remedy of recent help to me was Nuphar luteum, the yellow pond Lilly, with yellow, watery diarrhea, worse in the morning. A patient came for impotency. The combination of impotency and irritable bowel syndrome led to Nuphar. When there is great rectal tenesmus, Mercurius corrosivus gives the best relief. The "Mercuries" seem not to be relieved by stool or urination. Gambogia has great rectal tenesmus after stool. Sometimes there is constipation alternating with diarrhea. Rectal tension often leads to thin or pencil-like stools. Here, Phosphorus comes to the rescue. Remember the left upper quadrant pains of Momordica balsama, the balsam apple, often coming from the back to the front; the left lower quadrant pains of Trombidium; the right upper quadrant pains of Jatropha, similar in its forceful stools to Croton tiglium; the right lower quadrant pains of Belladonna, Bryonia, Mercurius corrosivus (caecal and transverse colon pains), Gelsemium (transverse colon pains), Gambogia (right lower quadrant very sensitive to pressure), Ginseng (pain and rumbling), and surprisingly, Lachesis. Lachesis is predominantly left-sided, but has many right-sided abdominal symptoms. Skin conditions continue to plague mankind. It is so tempting to use an antihistamine or a steroid cream to get quick results, but continued suppression of an external manifestation of illness in the present, as any homeopath knows, will only lead to more chronic disease in the future. In former papers I have talked about Formica rufa and Skookum chuck in eczema palmeris and plantaris. Boericke says this next remedy is "curative in disorders that exhibit interstitial inflammation and cellular proliferation. Great thickening of epidermoid layer and exfoliation of scales." Whether it be eczema, keratoses or psoriasis, Hydrocotyle, the Indian Pennywort, will afford excellent results. There is often intense itching, redness and scaly skin conditions, or circular spots with scaly edges, as in ringworm. Remember Tellurium for circular, ringworm-type lesions, and especially Bacillinum as the nosode. Classical psoriasis is usually located on the extensor surfaces of the elbows and knees. Kent lists only a few remedies in these rubrics: Phosphorus, Iris, and Kali arsenicosum. Remember Iris for its classical migraine headache symptoms with visual aura. Also, Iris has a strong peptic ulcer diathesis, with severe burning throughout the intestinal tract. Robinia is similar, but has more sourness to the symptoms and is also associated with headaches. Boericke describes Kali arsenicosum as effective for "inveterate skin diseases." The modalities are worse undressing like Rumex, but it is worse warmth, whereas Rumex is worse cold. Clark describes Chrysophanic acid, from Chrysarobinum, as a powerful irritant to the skin. The main symptoms being eczema behind the ears with oozing and large thick scabs, similar to Oleander or Scrophularia in scrofulous-like children. I have also used it with success in atopic conditions about the face and eyelids. Speaking of scrofulous conditions reminds me of swollen glands and sore throats and the remedies for mononucleosis. My first choice is often Cistus canadensis, the Rock Rose. Boericke says, "Malignant disease of the glands of the neck," but it has inflamed glands throughout the body. The keynote symptom being extreme sensitivity to cold air. Two other remedies to be considered are Aconitum lycotonin, the Great Yellow Wolfsbane, and Lapis alba, the silico-fluoride of calcium. In Lapis alba the glands are not as hard as Calcarea fluoratum or Cistus. Dr. Somerson wrote about Feldspar and Red Grape Seed as efficacious in mononucleosis. Through the years they have been of help to me when other remedies have failed. Boericke says these remedies should be considered for Hodgkin's. They certainly fit the picture well. Grindelia has very irritant qualities which cause a Poison ivy-type rash. Thereby, it has been a good remedy in Poison ivy-type rashes. Other aspects of Grindelia make it important in the differential diagnosis of cough and asthma. It is one of the "suffocative" remedies. Thick plugs of mucus obstruct the breathing. The patient wakes suddenly with a feeling of suffocation, soon after falling asleep (Cuprum metallicum is similar but wakes more towards 3 a.m.), gasps for breath, and cannot breathe lying down. Mephitis awakens blue in the face, gasping for breath with difficulty in exhalation, like Chlorum. Sambucus, too, is usually worse expiration, but is also listed in Kent in bold for worse inspiration. Aralia racemosa wakes with cough or asthma in the first sleep, several hours after falling asleep. Sticta pulmonaria coughs in the first sleep, but doesn't necessarily wake the child, only the parents. Remember Antimonium arsenicosum for more deep seated bronchial conditions like emphysema, where there is dyspnea on even slight exertion and lots of mucus expectoration. Senega is similar. It is said to be the remedy for "old men" with chronic bronchitis and emphysema, but the expectoration is thicker and very difficult to bring up. Squilla maritima is similar. Both Senega and Squilla have the keynote symptom of cough ending in a sneeze, like Agaricus. Squilla is one of the stress incontinence remedies . spurts of urine with each cough. Back pain is truly a "pain in the neck" wherever the location may be, cervical, dorsal or lumbar. A good spinal adjustment especially after a fall or trauma, like an automobile accident, can speed the recovery. My favorite Sciatica remedies are Colocynthis for pains running down the back of the thigh and Phytolacca for pains running down the lateral aspect of the thigh. You won't find a better remedy for sacroiliac pains than Aesculus hippocampus. Another remedy to think of in the rheumatic diatheses with aggravation in the cold, damp weather (other than Rhus toxicodendron, Dulcamara and Calcarea carbonica ) is Calcarea phosphorica. This remedy is often neglected in back pains. It has the modality of sacroiliac pains "as if broken." If anyone here has experienced low back pain, then you can easily relate to Calcarea phosphorica. When the only relief of pain comes from lying down, then Ammonium muriaticum should be considered. It is the only remedy in bold degree in Kent in the rubric . Sciatica, better lying. It has helped me in many instances. This is an interesting case of a college student, who had been treated homeopathically for many years. She was one of those chemically sensitive individuals, abbreviated MCS for multiple chemical sensitivities. She ate only organic foods and was bothered by most odors in the environment, like cleaning fluids, perfume, smoke, etc. She called me once saying she felt poisoned from asbestos removal at her apartment complex. She felt numb, as if the brain were swollen, with dizziness and difficulty walking. I told her to take an Alka Seltzer Gold, since it has several minerals in it which seem to help detoxify these kinds of reactions, and it did. However, the main reason for her seeking my help was for severe dysmenorrhea which plagued her since menarche. The pains started just before the flow and lasted twenty-four to forty-eight hours. She was totally disabled. She described stabbing pains over the uterus and ileocaecal areas, which doubled her up and radiated down the thighs. This was accompanied by lumbosacral pains and tight gluteals. The only relief was from very hot applications, and this took the edge off slightly. She often found herself passed out in bed, waking up in agony again. I started her with Colocynthis 30 in water to sip on an as needed basis during the pains. One month later she was five to ten percent better with the last menses. I gave her one dose of Lapis alba 200C and told her to continue the Colocynthis, as before. Two months later she returned saying, "I'm physically, emotionally and atmospherically better." The cramps were steadily getting better. "I'm able to function much better. It's nice after six years to be able to function." The clue to the remedy was a case I remembered from Dr. Richard Moskowitz, with the symptom of faintness from the pain. It is rewarding to be able to help someone to remove a dysfunctional burden so as to be freer for the rest of life's developments. This is the "Heart and Soul of Homeopathy." In recent years I have had an influx of a "new" disease entity labeled vulvar vestibulitis. There is chronic vulvar discomfort, characterized by burning, irritation or rawness of the female genitalia. Causes are sometimes linked to Herpes, Candida, or Human Papilloma virus, but most often the etiology is elusive. Treatments from Vulvectomy to laser surgery have been used with mostly unsatisfactory results. Antidepressants are often prescribed which seem to help, some. I have had some relief from the use of calendulated oil rubbed on the vulva twice daily. This Spring, a thirty-five year-old married woman came to see me for just such a case. Her history revealed past vaginal Herpes and HPV. She experienced Vulvodynia, since 1989. She had many treatments including antibiotics, antidepressants, cauterization, estrogen cream, acupuncture and Naturopathic treatments, without help. She had a sense of humor, is creative, career-oriented, artistic and worked well with others. However in the past few years she had been tired, emotionally labile, overwhelmed, anxious about death, especially of others, and felt "not good enough." She was somewhat of a perfectionist and did her work well. When asked about why she felt "not good enough," she said she had been ruminating about past situations and how they could have worked out better. She was particularly upset about a project she had been working on for the past year at work. She felt anger and resentment towards the project director, who she felt had usurped her authority. The combination of resentment and the genitourinary focus led to only one remedy, Staphysagria. I gave one dose in the 200C. Three weeks later she returned. She said she felt better. "It couldn't be the remedy, could it?" Her mood and energy were better, and the vaginal pain was less. She could enjoy intercourse with her husband again. The anger and resentment had eased some. Over the next six months she was able to put the resentments behind her, and she continued to improve on the one dose of Staphysagria. This is the "Heart and Soul of Homeopathy." Recently, a middle-aged man came to see me with the complaint of anxiety and depression. He said, "From time to time I get bouts of depression which are situational." He had always been treated with psychotropic drugs, and the depression would dissipate over time. His present depression started in February 1996 with insomnia and anxiety. He became more and more dysfunctional at work, to the point where he was on sick leave for the month prior to seeing me. He had been on six different antidepressant and anti-anxiety drugs with the only effect being side effects of the drugs. The core of the depression stemmed from an incident at work where he felt betrayed. He was extremely upset at the time and still harbored anger and resentment. I gave him a single dose of Staphysagria 1M. At our next appointment, three weeks later, he said he was "much better." His appetite had returned, and he had started to gain back the weight he had lost. He was calmer and sleeping better. He was working full time at home and would go back to the office that next week. I asked him what he had done. He said, "I decided to change my priorities. I will do more things for myself and enjoy life a little more." This is the "Heart and Soul of Homeopathy." A 55 year-old man came for the first time five months ago. His main complaint was arthritis. He had arthritic symptoms for the past thirty years and, needless to say, had been on allopathic drugs too numerous to count. Surprisingly, he had done quite well, with only mild progression of the illness. Then, five months before our first visit, he started a downward spiral which led to severe debilitating symptoms. He was given stronger allopathic medications, but his condition only worsened. Not only were the physical symptoms increasing, but he had general malaise as well. He was tired, lacked interest in life, was pessimistic, stopped reading, and slept a lot . all symptoms of depression. His most severe symptoms were in the morning, with great stiffness in the hands, hips and knees. Wet weather was his greatest aggravation. In taking the case, the aggravation started with a sprained wrist from overindulging in chopping wood. Ah! the rub. Aggravation after injury; worse morning and wet weather; hip and knee involvement. One dose of Natrum sulphuricum 10M and in two months he had seventy-five percent less pain and stiffness. Most importantly, he felt well generally. His energy was back and he was enjoying life again. He was doing aerobic walking in the morning and was off allopathic medications. This is the '"Heart and Soul of Homeopathy." A year ago, a distraught mother brought in her nineteen month-old son. She said her son had a runny nose "ever since birth." He had nine antibiotics in his short life and was on one at the present time. He even had two courses of antibiotics during the summer. He was most frequently diagnosed with recurrent otitis and sinusitis. The congestion often remained even during antibiotic treatment. My first treatment in congestion is to stop dairy products. The mother had already done this, without results. I'm old fashioned, so I started the child on cod liver oil for extra vitamin A and D, and extra vitamin C for the immune system. Because of the persistent congestion, I started the child on Bacillinum to stimulate the respiratory system. There were many phone calls in the next two months because of on and off congestion. I needed to comfort and encourage this mother that ups and downs were inevitable. We used low potency remedies like Pulsatilla, Hepar sulphuris, Kali bichromicum, Ferrum phosphoricum, and others for acute symptoms as indicated. Two months later, the mother said, " A remarkable two months; no antibiotics." It is now one year later and still no antibiotics. Healthcare is a give and take between doctor and patient. It is an ever growing understanding of the underlying nature of the patient and the homeopathic remedies that can create true changes in healing. This is the " Heart and Soul of Homeopathy." Last week a desperate mother called me to help her four month old who had a high fever for the preceding 10 days and was on the verge of having more invasive tests and possibly being hospitalized. The whole family had a stomach virus several weeks earlier, and this baby had diarrhea for the previous two weeks. The fever was low grade initially, then was 101 to 104 for the past week. Laboratory tests were negative, and finally the pediatrician found an otitis. However, antibiotics did not reduce the fever. On examination, the child looked peaked and was sluggish in his responsiveness. There was a mild otitis, but no other pathognomonic symptoms. I gave two doses of Pyrogenium, to be given twelve hours apart. The next day the mother called and said there was no improvement the rest of that day, but the child woke up the next morning without fever, and was back to his old normal self. This is the "Heart and Soul of Homeopathy." Thank you for allowing me to share my experiences with you.

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Case 2:04-cv-05525-BWK Document 158 Filed 05/02/2008 Page 1 of 26 IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA In Re: WELLBUTRIN SR : CIVIL ACTION DIRECT PURCHASER : NO. 04-5525 ANTITRUST LITIGATION MEMORANDUM AND ORDER Kauffman, J. May 2, 2008 Now before the Court is the Direct Purchaser Plaintiffs’ Motion for Class Certification.

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The Vine: [Matthew 13:1-9] This parable is talking about four different kinds of Christians: The ones who hear the word of the Kingdom of the heavens, but they do not understand the message of the Kingdom, so the wicked one snatched it away; the ones who received the Word of the Kingdom with joy, but did not endure when tribulations popped up; the ones who hear the message of the Kingdom, but

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