How to handle psychiatric diseases

• Specific?
• Should I prescribe on physicals?
• Should I prescribe on mind?
• Should I prescribe taking handful of rubrics which we know? Insanity, panic attacks? We always get the same symptoms: anger, rage, destruction, increased stamina, violence etc. and we will end up with Bell, Verat, Merc, Tarent - we will have some result and sometimes it is the only chance to bring the patient under control. But the problem will come back and the same remedy will not help all the time. It only helped because the sphere of action of these remedies is very similar to the patient´s symptoms.
• What potencies should I use? Should I repeat or better not repeat?
• Should I trust the mental history? Is it really a mental case? 

 

§ 215 

Almost all the so-called mental and emotional diseases are nothing more than corporeal diseases in which the symptom of derangement of the mind and disposition peculiar to each of them is increased, while the corporeal symptoms decline (more or less rapidly), till it a length attains the most striking one-sidedness, almost as though it were a local disease in the invisible subtle organ of the mind or disposition.

 

§216 

The cases are not rare in which a so-called corporeal disease that threatens to be fatal - a suppuration of the lungs, or the deterioration of some other important viscus, or some other disease of acute character, e.g., in childbed, etc. - becomes transformed into insanity, into a kind of melancholia or into mania by a rapid increase of the psychical symptoms that were previously present, whereupon the corporeal symptoms lose all their danger; these latter improve almost to perfect health, or rather they decrease to such a degree that their obscured presence can only be detected by the observation of a physician gifted with perseverance and penetration. 

In this manner they become transformed into a one-sided and, as it were, a local disease, in which the symptom of the mental disturbance, which was at first but slight, increases so as to be the chief symptom, and in a great measure occupies the place of the other (corporeal) symptoms, whose intensity it subdues in a palliative manner, so that, in short, the affections of the grosser corporeal organs become, as it were, transferred and conducted to the almost spiritual, mental and emotional organs, which the anatomist has never yet and never will reach with his scalpel.

 

This means: There has to be a bodily precursor somewhere; this is one of the ways how the mind can be affected - through the body. 

It can be from a trauma, emotions, situations in the family, loss of someone – or it can be from suppression of physical illnesses. 

We need to be very observant; children have a lot of pressure and in India the suicide rate of children has increased very much. But the child will not jump straight into a state of suicide, there had to be some symptoms before: anger, contradiction, rebellion, listlessness, less appetite, sleeplessness, mood swings, going gradually into mental disease.

 

Hahnemann told us, there are two ways to go into mental diseases 

1. Corporeal: Those that go on from body sufferings towards mind. (They go ascending from layer to layer and from psoric to sycotic to syphilitic Miasm.) 

2. Non-corporeal: Mind is affected first and then the body.

 

 

 

Nowadays we see that even small children tend to pick up the bad things more easily than the good things. This indicates that those children have a constitution that is predestined to take the bad things. 

Lifestyle-diseases like alcoholism or drugs come up in early age, but without the miasmatic background nobody will get addicted on drugs; it is not the “bad company”, which is blamed mostly.

 

This is very important to know, we can take better precautions if we know the destructive potential of the patient and the tendency to go into mental diseases (self-destructive or destructive behavior). 

Those people will go into criminal behavior or major insanity.

 

According to modern science 

A mental disorder, also called a mental illness, psychological or psychiatric disorder, is a mental or behavioral pattern that causes either suffering or poor ability to function in ordinary life. 

 

Nowadays “depression” or “psychological problems” is a term, which is used very freely. But we should know, what is really a psychological problem, what is really a depression and what are the symptoms and the origin of the disease.

 

Types of psychiatric disorder we have in our clinic 

• Anxiety disorder
• Mood disorder (bipolar)
• Psychotic disorder
• Eating disorder
• Impulse control or addiction disorder
• Personality disorder
• Compulsive disorder
• Post-traumatic disorder
• Sleep related disorder
• Dementia
• Alzheimer
• Schizophrenia
• Stress response syndrome (adjustment disorder)
• Dissociative disorder
• Factitious disorder
• Somatic disorder 
• Sexual & gender disorder 
• Tics disorder

 

In modern medicine we can go on naming the disorders. But as a Homoeopath we have to know, there has to be a basic problem, where all the problems have started. Each and every patient, who has reached a certain diagnosis e.g. schizophrenia, has to have started the disease on a lower level like anxiety disorder going to depression, OCD or mania etc.

 

 

Neurotransmitters

It is important to know about the physical effect of neurotransmitters, because in anxiety we will always have certain symptoms. E.g. in anger or anxiety more adrenalin is secreted; this has a certain effect on the body: heart palpitation, spasms, cramps etc. 

So we cannot take anxiety with heart palpitation (pathognomonic), those disease specific symptoms we have to avoid.

 

There are certain depressions, where the person is weak, lax, flabby and other depressions with palpitations, spasms or restlessness. 

We need to avoid those specific symptoms even if we can see them faster and more clearly than the true constitutional traits.

 

In schizophrenia a patient will hear or see things, will have hallucinations, can be in an exalted or paranoid state etc. and all senses will be acute. In such a case we cannot take this as an entry-point (exaggeration: psoro-syphilitic symptom). If we base our prescription on that, the certain symptom will go down but the more syphilitic symptoms will increase.

 

We have to know there are different ways to prescribe: physiological and constitutional/genetic (see Dr. Prafull Vijayakar´s seminar 2014).

 

Whenever physiology is at work, ailment from and psoro-syphilitic symptoms are important, but when it goes into a chronic problem, the acuteness of symptoms (psoro-syphilitic) should not be considered.

 

The classification of symptoms is always important. We have to know sycotic rubrics to avoid them. Similar in syphilitic cases: we have to know, in which particular pathology a certain grade of syphilitic symptoms is to be left out and which grade is to be our entry-point. And that is only possible if we know the amplified, distorted, perverted etc. symptoms. 

Usually we know the generals of Syphilis well, but we have to go one step further and know the gradation. 

Exaggeration means just the amplification of a symptom (anxiety amplified to anguish); if hearing is amplified, it gets acute; this amplification is still in control (psoro-syphilitic).

 

Syphilitic symptoms

 

Psora = MENTAL

• Anxiety, anticipation, sensitivity, irritability
• Faculties e.g. speed of speech, thinking 

Psora = PHYSICAL

• PAIN, inflammation, sensitivity
• Disease 

Psora = GENERAL

• Senses
• Craving, aversion, intolerance 

 

Aggravation can be psoric or syphilitic; amelioration is always sycotic.

 

Exaggerated anxiety:

• Anguish with restlessness: driving from place to place: Ars, Rhus-t, Acon, Bism
• Anguish followed by fainting: Nux-v, Verat
• Anguish with cold perspiration on the forehead: Verat
• Anguish, throws off covers with cold perspiration alternates with wanting of covers: Camph 
• Anxiety, nausea with: Ant-t, Ars, Bell, Bry, Ign, Kali-c, Nux-v, Tab … (43) 
• Clinging with: Stram, Carb-v
• Anguish, as if in blood: Sep
• Anguish causing palpitation, causing trembling 

 

These symptoms are important to us, when we treat physiological cases like acute high fever; if the case is more chronic like diabetes or growth, psoro-syphilitic symptoms will not help to find the remedy, because the body is more into Sycosis. If I want to reverse diabetes, I will need a symptom from a higher gradation of Syphilis. If I base my remedy on psoro-syphilitic symptoms, the diabetes will temporally get better, but will again shot up after a short time.

 

Distort means to bend, lie, twist, deform, alter, misrepresent, falsification, falsehood, misinterpretation etc.; many delusions come in this category. 

• Sense present but changed in feeling or seems different (feels like what is not)
• Delusion – feeling of 

 

Unnatural, perverse = not natural, abnormal, going against nature, atypical, strange, odd, uncommon, perverse 

Perversion = willful misunderstanding, false impression, inaccurate representation 

• Strange, odd, uneven
• Imagination, FANCIES
• Unrealistic
• Hallucinations
• Illusion – delusion – delirium 

 

E.g. if there are different syphilitic symptoms in a case of diabetes (acute senses but also fancies, eating feces etc.), the unnatural, strange symptoms are more important. Symptoms going against nature (eating feces, drinking blood) are very important.

 

Hysterical = panic stricken, out-of-control, frenzied, frantic, unpredictable, no boundaries 

REACTION OUT OF PROPORTION TO STIMULUS 

• ERRATIC
• Changeable
• Wandering
• Unpredictable, no axis
• Unprecedented
• Non-static
• Suddenness 

 

= OBLITERATION, ANHILATION, ABSENT 

• Senses absent
• Senses abolished or lost
• CONTROLS ABSENT
• Anesthesia 

 

The expression of those symptoms should not be because of the disease; e.g. you have numbness in diabetes, it is pathognomonic. 

But if there is numbness without any reason, numbness of a small spot, you can take it as entry-point to the case. 

It is very important to know the pathognomonic symptoms of a disease to find out the true constitutional symptoms.

 

SYPHILIS ON THE LEVEL OF SENSES:

 

Exaggeration = amplified overall or in spots 

à more important in psoric or sycotic cases

 

• Pains in spots (exaggerated) – too concentrated at a spot:Kali-bi, Ign, Sulph, Ox-ac, Arn, Lach, Con, Ars, Colch, Calc-p, Thuj, Nat-m
• Excruciating, lancinating, electric shock like pains with high peak, sudden pains 
• Sharp periodicity every day, same hour, same time (Kali-bi, Cedr)
• (Mother telling you that her child falls ill every first week of the month: if you find out, it is always the exact same day, shut your eyes and give Cedron – he has to be cured.)
• Pain violent, wants to cut off the part

 

DISTORTION 

All pains that are tearing, burning, stitching (Kali-bi, Ign, Nit-ac), twisting (he feels like the pain is tearing, but nothing is tearing inside = syco-syphilitic.) 

à more important in psoric or sycotic cases 

 

PERVERSION 

• Cold feeling in blood-vessels, coldness in bones
• Air sensation cold
• Ball sensation
• Air sensation hot (Aster, Bry, Kali-c, Puls, Sulph, Verat)
• Hot water trickling sensation
• Senses perverted (laughing, when in pain) 

 

HYSTERICAL 

• Erratic pains (Puls, Caul, Lac-c)
• Sudden shifting pains, wandering pains (Kalm, Puls, Kali-bi, Ign)
• Appear suddenly and disappear suddenly (Bell, Kali-bi, Nit-ac, Rhus-t, Arg-n, Mag-c, Phyt, Strych)
• Pain in crosswise direction (Bell, Chel, Chin, Lac-c, Seneg, Sil, Sulph, Verat)
• Fainting from pain (Cham, Ign, Cocc, hep, Nux-m, Nux-v, Valer, Sil)
• Violent behavior from pain (Aur, Cham, Hep) 

 

SENSES DESTROYED 

• Anesthesia: one-sided, mucus membrane, affected part, partial, a.f. anesthetic vapors, skin anesthesia < morning on waking, anesthesia in small spots, after eruptions are suppressed
• Analgesia (Lyc, Cocc, Plb, Olnd, Op, Ph-ac, Stram, Hyos, Sulph, Cic)
• Inner parts (Op, Plat)
• Parts affected (Plat, Lyc, Cocc)
• Perspiration during
• Form abuse or poisoning with analgesic, anti-grippals, anti-pyretics, coal-tar drugs
• PAINLESSNESS OF COMPLAINTS OTHERWISE PAINFUL (often in heedless children: we know, that Syphilis is lurking in such constitutions.) The body tries to present the miasmatic symptoms on every level; only if I know, this is a symptom of a certain Miasm, I can use it.

 

SKIN DESTROYED 

• Atrophy of skin
• Bazin´s disease, erythema induratum
• Bedsores – decubitus 

 

SENSES EXAGGERATED 

• Hyperesthesia (Asaf, Bell, Cham, Coff, Hyper, Lyss, Ther, Ign) 
• Slight touch aggravation (Acon, Apis, Bell, Chin, Lach, Merc, Nux-v)
• Sensitive to touch
  • Throat (Lach, all snakes, Hep, Phyt)
  • Abdomen (Lyc, Nux-v, Graph, Carb-v, Nat-s, Arg-n, Lach, Crot, all snakes, Calc, Bov, Hep, Coff) (navel: Lyc, Med) 

 

SENSES HYPERACUTE
(Acon, Asar, Asaf, Bell, Cham, Coff, Colch, Ign, Nux-v, Op, Phos) 

 

SENSES PERVERTED
(Arg-n, Op)

 

DISCOLORATION OF SKIN 

Discoloration of skin is very important; but you have to remember, that you cannot take any of these symptoms, if the discoloration is because of the pathology. 

• Black-blue – ecchymosis
• Black
• Bluish
• Green (Zinc)
• Red
• Brown (liver spots)
• Copper colored skin / spots
• Yellowish
• Dirty/ dirty gray/gray spots/ dirty brown / dirty green / dirty greenish spots
• Mottled skin /mottled in spots / around ulcers / mottled washing after
• Orange
• Pale (pale spots – Lach)
• Purple

Purple discoloration: There is often confusion between blue and purple colored lesions. Hence a differentiation between the two has to be emphasized. The purple colored skin, mucus membrane, ulcer, eruption etc. can practically be seen as having a mixture of reddish-blue hue. Most of the time a carbuncle is seen to be a classical example of purple lesion i.e. reddish blue.

 

 

• Purple around wounds (Crot-h, Lach)
• Purple around eruptions (Crot-h, Lach, Vip)
• Carbuncle purple with vesicles around (Crot-h, Lach)
• Urticaria purple (Chin-s)
• Measles purple (Acon, Bell, Coff, Nat-m)
• Purple discoloration after suppressed eruptions (Abrot)
• Purple discoloration of inflamed parts (Sulph)
• Purple spots (Sec, Agav-a, Vip)
• Purple scarlatina (Mur-ac)
• Nails discoloration purple – finger nails (Androc, Apis, Ars, Op, Samb, Sec, Stram)
• Hands discoloration purple – hand (Apis, Kali-c, Kali-p, Lach, Naja, Op, Phos, Rhus-t, Sec, Sep, Thuj, Vip)
• Hands – discoloration purple – in spots (Kali-c)
• Purple spots on forehand as in lichen planus, psoriasis, scleroderma (Kali-c, Kali-p)
• Eruption or rash purple on face (Hyos, Sep)
• Gums purple, thin border (Plb)
• Tongue purple black (Op)

 

Example:
Patient with psoriasis – the color of the lesion was bluish/purple (normal is grayish and slightly reddish); this color is known to be there in remedies from the animal kingdom. The patient was very money oriented and good in planning; he was a Homoeopath, but went about his clinic like it was a business, advertising etc. àhe got Tarent-c.

 

VISION – EXAGGERATED 

• Acute
  • Daytime (Choc)
  • Morning (Bamb)
  • In sunlight (Anh)
  • Sees even in dark (Valer)
  • At night in hysterias (Ferr)
  • For small objects (Calc, Coff, Hep)
  • Very good accommodation after change of light
  • Stereoscopic hyperacute (Anh)

• Photophobia
  • To artificial light
  • Candle light, gas light
  • To chronic light, focused light, spotlight
  • Without inflammation (if there is pathology of eye, it is pathognomonic) 

 

VISION – DISTORTED (Bell, Bufo, Nux-m, Nux-v, Stram)

• Hemiopia
• Diplopia (Aur, Gels, Hyos, Nat-m, Nit-ac)
• Triplopia
• Objects seem brighter, dark room, in (Valer)
• Contrast increased
• Confused vision
• Confusion of color
• Vision dazzling, flickering, fire, glittering
• Objects seem distant (Gels, Sulph)
• Objects seem larger, enlarged
• Objects seem smaller
• Objects seem elongated
• etc. 

 

VISION – UNNATURAL 

• Photomania 19 remedies (Stram, Gels, Sulph, Tarent, Verat etc.)
• Colors before eyes
• Sparks (Bell, Chin) black, blue, green, red, white
• Letters disappear reading when, moving letters, run together, turning in circle, dancing, unable to distinguish
• Illusion, sees bugs, insects
• Images for long retained (Gels, Calc, Phos, Lac-c, Nat-m)
• Example: A patient saw an accident between a truck and a bike; she was not frightened or anything, but even after some time she always had the image of that man lying on the ground before her eyes.

 

VISION – DESTRUCTION 

• Color blindness for blue
• Color blindness
• Night blindness
• Blindness
• Scotoma 

 

First you have to look for a syphilitic symptom from the level of mind; if you don’t find it there, try the generals and after that the senses. When you got something, you have to grade it.

 

Questions and answers:

 

P: If the vision is disturbed in cases of migraine, does this symptom belong to the disease or to the constitution?

AV: It is part of the constitution and therefore important.

 

P: In your earlier seminar you stated, that discoloration of skin is sycotic because of the hyperpigmentation.

AV: Yes, the base is Sycosis; if it is a specific color or a specific region, it becomes more syphilitic.

 

P: If a person sees objects far away and small during high fever, can we take those symptoms?

AV: If this occurs recurrently, definitely yes.

 

P: If such a symptom was there in the past history, can we take this?

AV: It shows a syphilitic trait in the patient and should be taken into consideration. If it is not a repetitive phenomenon, it means that the body tries to maintain this particular syphilitic force. The syphilitic signs can come and go; but after a silent phase it could come back more severe and dangerous.

 

P: What about a patient, who tells you, he was outside his own body during fever?

AV: It could be important, because it could be a sense of false perception, delirium, delusion etc. This could also happen in a “near-death-experience”.

 

To find the syphilitic symptom may be difficult at the beginning, but if you practice it in each and every case, it will become a reflex action and therefore easy. For that you have to know exactly, what are the precursors and the types of Syphilis. 

If you don’t find a syphilitic symptom on the level of mind or the senses, you can turn towards the generals. 

We have to probe the patient from all directions.

 

SYPHILITIC GENERALS 

• Faintness, fainting attacks
• Convulsions with consciousness, sleep after
• Memory loss of, memory weakness (names, what he wants to say etc.)
• Confusion or confounding (time, relations, money, direction, sides, for different things, we need to look for it from childhood to adulthood); those symptoms should be repetitive.
• Trembling without pathological cause
• Appetite ravenous, canine, excessive
• Hunger aggravates – Anac, Sulph, Sul-i, Sep
• How does eating suit the body of the patient
• Desires indigestible things
• Appetite loss of – complete
• Appetite without satiety
• Appetite increased with emaciation – Ars, Nat-m, Sulph
• Emaciation single parts, one side, only legs
  E.g. in autoimmune disease the whole body usually becomes emaciated gradually; if you find the emaciation only on single parts, it is something special and tells us something about the constitution.
• Numbness one-sided 
• Nausea
  • After suppressed eruptions
  • Eating aggravation
  • On looking at food
  • Excitement from
  • Exercising from
  • Exertion of eyes from
  • From talking, from walking etc.
  • In children in the morning, while brushing the teeth
  • Nausea means discontent in the body – the nausea is accumulating and goes to the level of disgust; it is a physical symptom, but it has to have a representation on the mental level also. Maybe the child doesn’t like to go to school, because the teacher is insulting him or because of some other reason.

• Sleepiness overpowering, sleepiness during eating
• Falling asleep while reading
• Confusions after eating, sleep after etc.
• Sleep overpowering
  • Reading while, eating while, working while
  • Every day at same hour

• Throat sensitive internally
• Throat sensitive externally
  • To touch
  • To air
  • To clothes
  • Tight collars
  • Thyroid gland
  • Jaw angles
  • Head, scalp

 

We have other remedies, who like and are better from tight cloths. Those remedies can even            have agg from loose cloths; complaints start when clothes are removed.

• Perspiration
  • What time is the perspiration; where is the perspiration?
  • Spots
  • Single parts
  • Cadaverous odor
  • Acrid, acidic 

Example:
I examined a patient and his undershirt had several yellow spots on it. The wife said even when freshly washed, the stains did not go. This patient had a very acrid perspiration on spots. These things give an insight in his nature also. 

 

The syphilitic entry-point can be tiny but will open the case to us, Psora and Sycosis will get covered automatically. Usually we know the psoric and sycotic part of a particular remedy well, when we go from the repertory side, we are deciphering the syphilitic elements of a remedy.

 

Following symptoms also indicate Syphilis

• Partial heat
• Coldness of certain parts
• Perspiration in isolated parts
• Peculiar odors from body
• One-sidedness
• Peculiar excess discoloration
• Unrelated symptoms – giddiness > from motion; headache while silence 

 

Aggravations are psoric or syphilitic. 

Ameliorations are generally sycotic; but also there are some syphilitic ameliorations; mostly these are contradictive or concomitant symptoms and they are most important if they are not pathognomonic. 

Curing of syphilitic cases is much easier than curing sycotic cases! Syphilis is giving us symptoms, but Sycosis is covered up not showing anything to us. 

And also we need to understand the Psora of a patient. 

Even when we try to reach for the syphilitic symptom, we can falter. When we get hold of the syphilitic symptom and prescribe on it, it will only come to a complete reversal of symptoms if we took the Psora into consideration, otherwise it will get stuck up in Sycosis. 

If there is a symptom, which goes through the whole case, it is most important. E.g. if the patient has several syphilitic symptoms, but there also was a confusion going on from childhood until now, the confusion has to be covered by the remedy!

 

Sources:
Seminar Ambrish Vijayakar in Nov. 2015 in Regensburg, seminar transcript Renate Greißl
Samuel Hahnemann, Organon of Medicine, 6. Edition; Jain Publishers, New Delhi

 

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