CEDH Magazine May 2017

THERAPEUTIC FILES

Practitioner’s improvement

Every day Practice

When baby arrives

Complications in premature newborns: how the homeopathic physician can help?

Colics in infants

History & Culture

Materia Medica

The clinical homeopathy of Dr Beauvais de Saint-Gratien. Who were the precursors of homeopathy?

Causticum (part 2) Kalium iodatum Mercurius cyanatus

Teaching Clinical Homeopathy

CEDH magazine C O N T I N U I N G M E D I C A L E D U C AT I O N C E D H M A G A Z I N E • M AY 2 0 1 7 • N U M B E R 4 4

SUMMARY

CEDH magazine 3 EDITORIAL ,

Yves Lévêque, MD, 03

44 N°

Published by CEDH, 38, rue des Mathurins, 75008 Paris - www.cedh.org

Editor in Chief : Yves Lévêque, MD Editorial board : Yves Lévêque, MD Frédéric Voirin, MD Contributors for this issue : Jean-François Becker, MD Franck Choffrut, MD Ibtissem Hafsa Tamboura, MD Dr Anne Le Bars-Crassous, MD Josette Nouguez, MD Martine Tassone-Saillard, MD Production : Atelier Chalopin Sérigraphie Editing : Élodie Ther Translator : Bénédicte Clement Illustrations : Fotolia Printing : ISSN : 1950-8832 Legal mention : 0516 T 88691 Publication date : May 2017.

4 THERAPEUTIC FILES WHEN BABY ARRIVES

Anne Le Bars-Crassous, MD, 04

8 PRACTITIONER’S IMPROVEMENT

Complications in premature newborns: how can the homeopathic physician help?

Ibtissem Hafsa Tamboura, MD, 08

13 EVERYDAY PRACTICE

Colics in infants Martine Tassone-Saillard, MD, 13

17 HISTORY & CULTURE

The clinical homeopathy of Dr Beauvais de Saint-Gratien Who were the precursors of homeopathy?

Jean-François Becker, MD, & Franck Choffrut, MD, 17

25 MATERIA MEDICA

Kalium iodatum , 25 Causticum: The patient’s individual reaction and sensitive type at all ages , 27 Mercurius cyanatus , 30

MAY 2017 CEDH MAGAZINE

Josette Nouguez , MD

2

EDITORIAL

The Future Yves Lévêque, MD Editor in Chief

T

he main themes of the 44th issue of our CEDH Journal include the premature baby, newborn, infant and her mother, a beautiful life evolution that makes us long for the future!

Our different sections: physician’s improvement, daily practice, therapeutic file, Materia Medica, make us reflect on clinical homeopathy practice today to strenghten, consolidate, guide and build our future as well as the one of our patients, who will become adults, that’s for sure!

There is no future without a past. This is why a culture article is here to show us the importance of history and the fundamental bases of homeopathy.

Future is also the present! The CEDH’s present is vital, with the integration of new teachers, in a close future the integration of new modules and the speeding up of the international development of the CEDH. All these elements As for are the promises of a bright future!

‘‘

the future, your task is not to foresee it, but to enable it.”

The future is you and us, and our presence at the Barcelona conference on October 6-7, 2017, will confirm the role that homeopathy must endorse and will consolidate it as a medicine of the future.

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What conclusion for the future?

I leave it to Antoine de Saint-Exupéry: “Preparing the future is about funding the present (…) It is only about the present to be put in order. Why discuss this heritage ?

As for the future, your task is not to foresee it, but to enable it.” ■

3

THERAPEUTIC

FILE

When baby arrives Dr Anne Le Bars-Crassous

H

ere we are, finally baby is here! And even if “it is the most beautiful day of one’s lives” one should keep in mind that giving birth is always a physical and emotional challenge for the mother and her baby (quite often also for the dad, but this is another debate).

As homeopaths we will of course be attentive to all these changes in order to easily bring help and comfort during the first days of postpartum.

1

Always care for the new mother with benevolence!

When everything goes well, the arrival of the new baby does bring for the mother a certain number of inconveniences (perineal trauma, bleeding hemorrhoids, breast tension) and psycho-affective changes starting with her new status (from woman to mother, and when she was the center of attention during the pregnancy, the baby is now the object of all longings…).

PERINEAL CARE APIS MELLIFICA 15 CH on the notion of edema, 5 pellets every hour, space out according to improvement.

ARNICA MONTANA 9 CH (anti-inflammatory and anti-bruising action), 5 pellets every hour then space out according to improvement.

FOR AN EPISIOTOMY

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STAPHYSAGRIA 15 CH

4

SYSTEMATICALLY: ■ if possible take Arnica montana 15 CH repeatedly during the delivery.

■ Do not hesitate to give Arnica montana 30 CH, 1 dose right after delivery.

■ In case of delivery-related hemorrhaging or history of hemorrhages during a previous delivery, Phosphorus 15 CH 1 dose.

■ In case of intense headaches following an epidural: Natrum sulfuricum 30 CH 5 pellets 2 or 3 times a day.

5 pellets morning and evening for 8 days (not necessary if the mother benefited from a 15 CH dose in prevention at the beginning of labor and right after delivery).

IN CASE OF PERINEAL/VAGINAL /ANAL TEARS NITRICUM ACIDUM 15 CH 5 pellets morning and evening until the wound is healed.

We are talking here about a fissure with clear

THERAPEUTIC

FILE

When baby arrives borders and a sensation of burning, stinging, splinterlike pain, which bleeds easily.

lengthening of the muscle fibers, the increase in uterine volume is greater) and they often last 3 to 4 days, sometimes longer.

IN CASE OF MAJOR TRAUMA BELLIS PERENNIS 5 CH 5 pellets 3 times a day for a few days.

Bruising very sensitive to the touch, with sensation of broken bones in the pelvis in a woman unable to walk after the delivery.

OF NOTE, they are more intense for breastfeeding mothers because of the oxytocin secretion. As a matter of fact, if the hormone is responsible for the contraction of muscle fibers around the milk ducts, it also leads to the contraction of uterine muscles.

HEMORRHOIDS WE QUICKLY UNDERSTAND THE RELEVANCE OF

AESCULUS HIPPOCASTANUM 5 CH

HOMEOPATHIC MEDICINES DURING THESE

Given almost systematically for turgescent hemorrhoids, not bleeding much, sensation of a full rectum, burning and stinging pain “like needle pricks”, and improvement by local cold.

“DISCOMFORTS”.

OCYTOCINE 15 CH HAMAMELIS 5 CH Bluish, swollen hemorrhoids that bleed easily and profusely, bruising and bursting sensation.

RATANHIA CREAM 4 % MT Hemorrhoids +/- anal fissures; acute and burning pain “like glass shards” during a bowel movement and persisting for a long time afterwards.

Apply several times a day then space out according to improvement.

COLLINSONIA CANADENSIS 9 CH Very frequently seen in case of hemorrhoids with pruritus in a context of constipation with hard and voluminous stools, sensation of “rectum full of needles”. Improved by bleeding.

MURIATICUM ACIDUM 9 CH Turgescent, blue hemorrhoids, contact hyperesthesia and improvement by local heat (hot baths).

POSTPARTUM CRAMPS OR WHEN THE UTERINE CONTRACTIONS CONTINUE!

According to the symptoms, we will add 5 pellets every hour or before each breastfeeding session (space out according to improvement) of:

CAULOPHYLLUM THALICTROIDES 15 CH for cramp-like pain; or:

COLOCYNTHIS 15 CH for cramping pain improved by heat and being bent over in two; or:

CUPRUM METALLICUM 15 CH for spasmodic pain with sudden beginning and end.

2

Help the mom to breastfeed…or not!

The French Drug Agency warns that the “use of a medicine to inhibit lactation should be confined to situations where lactation inhibition was needed for medical reasons.

The systematic take of a medication inhibiting lactation to prevent or treat discomfort or breast engorgement during breastfeeding is not recommended”. As such since July 2013,

MAY 2017 CEDH MAGAZINE

AS A REMINDER these are painful uterine contractions occurring after delivery that have 3 essential functions: allowing spontaneously and naturally the “ligature” of the blood vessels that fed the placenta, allowing the uterus to go back to its original size and finally enabling to clean the uterus by evacuating blood clots and waste material (lochia). These cramps are intermittent, occurring in bursts, their intensity and frequency increase along with the pregnancies (because of the

5 pellets timed with the breastfeeding sessions.

5

THERAPEUTIC

FILE

When baby arrives

Bromocriptine (Parlodel®) is no longer part of the therapeutic array.

By chance, and regardless of how the mother chooses to feed her child we have in our toolbox several extremely precious and effective medicines to help the mother when her milk is coming in.

PROTOCOL FOR LACTATION SUPPRESSION OR WEANING FROM BREASTFEEDING: ■ Lac caninum 30 CH, Apis mellifica 15 CH, Bryonia 15 CH 5 pellets of each 6 times a day, between 4 and 10 days after delivery for lactation suppression.

■ We can sometimes use Belladonna at the beginning of an inflammation but more rarely in the first breastfeeding week.

■ In case of failure, think of Dopamine 15 CH (dopamine has an inhibiting action on the prolactin secretion; we use it in high dilutions to stimulate the secretion of prolactin).

3

Baby blues (commonly occurring 3 to 5 days after giving birth) SEPIA OFFICINALIS 15 CH

5 pellets once a day.

Withdrawal, does not want to see her loved ones, cannot stand the baby crying.

Aggravated by consolation; “needs to be left alone”.

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PULSATILLA 15 CH

6

FOR DELAYED ONSET OF LACTATION OR TO STIMULATE LACTATION : ■ Ricinus communis 5 CH +/- Lac caninum 5 CH 5 pellets, 3 to 4 times per day, space out according to improvement.

5 pellets once a day. Cries a lot, needs the help of her mother or a maternal substitute.

Improved by consolation and encouragement.

IGNATIA AMARA 15 CH 5 pellets once a day.

Strong anxiety, sensation of lump in throat and

THERAPEUTIC

FILE

When baby arrives respiratory oppression.

Cries in public.

Improved by distraction (TV, etc.), frequent sighs and yawns.

4

Always take care of the baby with tenderness!

Sometimes with a homeopathic treatment!

By taking care of the mother, we already started taking care of the baby. As a matter of fact, when mom feels good baby is relaxed and serene. Most times, that is enough. However, sometimes the delivery was difficult with trauma and homeopathy can play a great role to help baby.

One can imagine that when the delivery was complicated with trauma for the baby, there might be some anxiety and stress perceived by the child.

a benign and common lesion that regresses spontaneously and disappears in 2 to 6 days.

Cephalohematoma is a subperiosteal hematoma appearing after 2 to 3 days of life and disappearing slowly over several weeks.

ARNICA MONTANA 15 CH 1 dose as soon as possible + regular takes in case of cephalohematoma.

In case of secondary calcification (like a ping-pong ball), one can think of

SOLANUM MALACOXYLON

EXCORIATION OF THE SCALP These skin lesions can represent an entryway for infections.

PYROGENIUM 9 CH or 15 CH 1 dose to be repeated twice at an 8-hour interval.

CHAMOMILLA VULGARIS 15 CH GELSEMIUM 15 CH 10 pellets to be dissolved in 10ml of water to be given at regular times during the day for several days (using a pacifier medicine dispenser if the mother is breastfeeding).

frequent takes, space out according to improvement, agitation linked to the pain, improvement by rocking the baby.

CLAVICLE OR LIMB FRACTURES CAPUT SUCCEDANEUM OR CEPHALOHEMATOMA “Caput succedaneum” refers to swelling, or edema, of an infant’s scalp formed by effusion of serum and blood. It takes the form of a lump or bump appearing on their head shortly after delivery. In most cases it is

ARNICA MONTANA 9 CH SYMPHYTUM OFFICINALE 5 CH to be repeated several times a day, at first to act on the pain but continue for a month to promote bone consolidation.

NEONATAL BRACHIAL PLEXUS PALSY Paralysis of the upper limb following the stretching (or tearing) of the roots of the plexus.

HYPERICUM PERFORATUM 15 CH do not hesitate to prescribe it over several weeks.

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Of course this article is not an exhaustive one, but it is my clinical practice and I am happy to share it with you, determining the level of dilution should be done according to the CEDH consensus. ■

7

PRACTITIONER’S

IMPROVEMENT

Complications in premature newborns how can the homeopathic physician help?

Ibtissem Hafsa Tamboura, MD

P

remature births constitute a Public Health issue. The incidence is about 5 to 8% of all births. The mortality remains high in spite of medical advances (20% of cases). The care management of the mother-child couple must be adequate to prevent complications on the short, medium and long term.

In this article, we will underline the possibilities of homeopathy during the different steps of this care management.

1

At birth

The vital prognosis can be endangered secondarily to the different causes detailed below

• The transient tachypnea of the newborn related to the absence of lung fluid resorption, even more when the newborn was born by C-section, in addition to the treatment listed above, WE CAN ADD:

RESPIRATORY DISTRESS It occurs directly at birth and can be related to: • Hyaline membrane disease due to the immaturity of the pulmonary surfactant.

Aside from the administration of steroids to the mother in antenatal and the respiratory assistance,

■ Bryonia 9 CH, ■ Antimonium tartaricum 9 CH and ■ Ipeca 9 CH.

NEONATAL INFECTION It can occur either in the framework of a neonatal maternal to fetal infection, or a nosocomial infection.

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WE WILL ASSOCIATE:

8

■ Carbo vegetabilis 9 CH: to act on the hypoxia, ■ Arsenicum album 9 CH: indicated on the notion of respiratory distress with vital risk, ■ Phosphorus 30 CH: risk of hemorrhaging and pulmonary superinfection;

WE WILL ASSOCIATE TO THE ANTIBIOTIC TREATMENT: ■ Hepar sulfuris calcareum 30 CH, ■ Pyrogenium 9 CH and ■ Phosphorus 30 CH systematically;

PRACTITIONER’S IMPROVEMENT

Complications in premature newborns: how can the homeopathic physician help?

■ Mercurius solubilis or Mercurius corrosivus 9 CH in case of associated stomatitis, ■ Natrum sulfuricum 9 CH in case of infection at the base of the left lung; ■ Kalium carbonicum 9 CH if the base of the right lung is affected; ■ Aviaire 9 CH when the apex of the lungs are affected; ■ Monilia albicans 15 CH to prevent antibiotic-related yeast infection.

• IN FAVOR OF PHOSPHORUS: prone to hemorrhages, major jaundice, lanky morphology, skinny and tall, quickly soothed by cuddling.

HYPOGLYCEMIA It is related to insufficient glycogen stores. It can be asymptomatic or can manifest itself by bouts of cyanosis and/or jitteriness or spasms,

LEADING US TO ASSOCIATE

■ Cuprum 9 CH to glycemic correction.

PROBLEMS RELATED TO LIVER IMMATURITY

HEMORRHAGIC SYNDROME

OTHER METABOLIC DISORDERS

It is related to the insufficient production of coagulation factors. It can lead to bleeding in the different territories that can endanger the infant’s life.

HYPOCALCEMIA WE ASSOCIATE ■ Cuprum 9 CH to the calcemic correction.

TO PREVENT THIS RISK, ■ Phosphorus 30 CH will be systematically prescribed for each premature infant.

HYPONATREMIA It is rare,

HYPERBILIRUBINEMIA 90 % of premature infants present with a physiological jaundice due to liver immaturity. In addition to phototherapy,

WE ASSOCIATE THE CORRECTION OF HYPONATREMIA TO

■ Natrum muriaticum 9 CH and ■ China rubra 9 CH.

WE RECOMMEND TO ASSOCIATE

■ Chelidonium majus 5 CH to the Sensitive Type medicine.

Most often newborns with the Sepia, Lycopodium and Phosphorus Sensitive Types are concerned.

• IN FAVOR OF SEPIA: The notion of a Sepia mother, ligamentous laxity, umbilical hernia, protrusion of the rectal mucous membrane, brown coloration of the median abdominal line, early eczema that can be generalized or located to the skin folds as well as GERD and refusing maternal milk.

It is a severe pathology consisting in hemorrhagic necrosis of the intestinal mucosa.

It is caused by several factors, related to ischemia, infection, alteration of the immune system.

To the classic rescussitation procedures

WE ASSOCIATE

■ ■ ■ ■ ■

Phosphorus 30 CH, Arsenicum album 9 CH, Secale cornutum 9 CH, Mercurius corrosivus 9 CH and Nitricum acidum 9 CH.

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• IN FAVOR OF LYCOPODIUM: delayed elimination of the meconium, abdominal bloating, GERD, tall and lanky infant, a screamer, frequent eczema and family history of metabolic disorders, high blood pressure, migraine, atopic disorders and renal disease.

NECROTIZING ENTEROCOLITIS (NEC)

9

PRACTITIONER’S IMPROVEMENT

Complications in premature newborns: how can the homeopathic physician help?

In parallel to caring for the newborn, the psychological and general support of the mother is very important.

It ensures the proper continuation of the maternal breastfeeding.

NEUROLOGICAL COMPLICATIONS WE WILL USE: ■ Lycopodium clavatum 9 CH: starving newborn who is quickly satiated; ■ Silicea 9 CH: frail newborn with fine bones, large head, fragile on an immune system level; ■ Natrum muriaticum 9 CH: thin newborn, not gaining weight in spite of proper nutrition, who had hydro electrolytic disorders, often anemic (associated to China rubra 9 CH and Ferrum metallicum 9 CH).

INTRAVENTRICULAR HEMORRHAGE It is related to the absence of self-regulation of cerebral blood flow and can progress to a delayed hydrocephalus.

■ Phosphorus 30 CH and ■ Arnica montana 15 CH will be associated to the conventional care management.

PERIVENTRICULAR LEUKOMALACIA With an ischemia of the white substance.

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IT IS THE INDICATION FOR ■ Secale cornutum 9 CH and ■ Arsenicum album 9 CH.

2

10

3

Long-term complications BRONCHOPULMONARY DYSPLASIA It is caused by several factors and

BRINGS UP THE INDICATION OF ASSOCIATING:

Medium-term complications The care management of the newborn on a nutritional level is essential due to the risk of delayed growth.

■ Ipeca, ■ Antimonium tartaricum, ■ Arsenicum album and Carbo vegetabilis.

TO THE TERRAIN TREATMENT WE WILL ASSOCIATED : ■ Silicea and ■ Aviaire in weekly doses and high dilutions.

PRACTITIONER’S IMPROVEMENT

Complications in premature newborns: how can the homeopathic physician help?

NEUROLOGICAL COMPLICATIONS Consisting mostly in sequelae of perinatal asphyxia with sensory disorders, nervous paralysis or paresis, behavioral disorders, psychomotor delay.

ACCORDING TO THE SYMPTOMS, SEVERAL MEDICINES CAN BE PRESCRIBED: ■ Causticum 15 CH, ■ Baryta carbonica 15 CH, ■ Calcarea fluorica 15 CH, ■ Mercurius solubilis 15 CH, ■ Luesinum 30 CH, ■ Silicea 30 CH and ■ Plumbum 30 CH.

4

How to administer pellets in the premature infants?

NEWBORN FED PER OS Dilute the pellets in water and give the solution to the baby to drink.

NEWBORN HOSPITALIZED IN THE INTENSIVE CARE UNIT Diluted pellets will be administered by dropping small quantities of the solution in the newborn’s mouth or by tube feeding after nasogastric feeding and aspiration of the gastric residuals (GRs) Takes must be repeated every 30 minutes to 2 hours according to the severity of the clinical picture.

5

Relevance of the motherchild couple management

FELIX Felix, born at 36 weeks of gestation, birth weight: 2.300 kg, Apgar 9/10 is seen at D8 of life for jaundice with a 200g weight loss.

The newborn looks frail, older, wrinkles very jaundiced.

• Bilirubin: Bil T: 140 mg/l. conjugated bil: 50 mg/l • Elevated transaminases: SGOT 150 ui/l, SGPT: 135 ui/l • Hemoglobin: 15 g/l • Infectious workup: CRP, negative TORCH serology screens.

The interview finds the notion that the mother took Nibiol during the last trimester, the diagnosis of toxic hepatitis is made.

AFTER A WEEK OF TREATMENT WITH: ■ Phosphorus 30 CH, ■ Arsenicum album 9 CH, ■ Lycopodium clavatum 9 CH and ■ Chelidonium majus 5 CH,

we noticed a spectacular improvement with: • Weight gain of 500 g with exclusive maternal milk • Drop in the transaminases levels: SGOT: 80 ui/l – SGPT: 75 ui/l • Drop in the bilirubin levels down to 80 mg/l without needing phototherapy.

Today, Felix is 18 and in good health.

AMIRA Amira, born by C-section from a twin pregnancy at 36 weeks of gestation with a nuchal cord, presents with neonatal respiratory distress with a positive infectious work up: CRP at 100 mg/l and WBC count at 20 000 with 80 % of neutrophils. She is put under three antibiotics (amoxicillin, cefotaxime and gentamycin), oxygen therapy with a mask.

After a week of treatment, in spite of the proper evolution on a respiratory and infectious level the newborn cannot be weaned from the oxygen therapy, in spite of several attempts.

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In parallel to caring for the newborn, the psychological and general support of the mother is very important.

It ensures the proper continuation of the maternal breastfeeding. Parents, especially the mother, are often prescribed homeopathic medicines to overcome this difficult time when the premature newborn is hospitalized.

6

Some clinical cases

11

PRACTITIONER’S IMPROVEMENT

Complications in premature newborns: how can the homeopathic physician help?

WE TRY TO ADMINISTER THE FOLLOWING HOMEOPATHIC TREATMENT: ■ Carbo vegetabilis 15 CH, ■ Arsenicum album 9 CH and ■ Lachesis mutus 9 CH.

After a few hours, the weaning was possible and the baby left the clinic the next day.

IHSEN Ihsen, born by C-section at 36 weeks of gestation is seen at the age of 7 months for: asthma with continuous dyspnea, GERD with Stage II esophagitis, severe hypotrophy (weight 6.800 kg, size 65 cm).

His pediatrician prescribed steroids and inhaled bronchodilators, repeated courses of antibiotics, PPIs and proper diet.

The interview underlines that Ihsen was hospitalized in the NICU at 1 hour of life for a digestive hemorrhage.

PROTOCOL TO BE OBSERVED: ■ Hypercaloric, hyperproteic diet; ■ Phosphorus 30 CH, ■ Arsenicum album 9 CH, ■ Ipeca 9 CH, ■ Natrum muriaticum 9 CH and ■ Silicea 9 CH: 5 pellets of each dissolved in some water and administered throughout the day.

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The evolution was positive after a month of treatment with decrease and stopping the inhaled bronchodilators.

Today, Ihsen is an healthy 8-year-old without any chronic disorders in spite of a few rhinopharyngitis episodes during his childhood.

12

ASMA Asma, born by C-section at 34 weeks of gestation in a context of perinatal asphyxia with mild meningeal hemorrhage is seen at the age of 6 for asthma and behavioral disorders.

The child is hypothropic, fearful, skittish, with hemiparesis on the right side with spasticity of the limbs, nighttime enuresis, shyness, difficulty adjusting to school.

THE TREATMENT PRESCRIBED FOR 3 MONTHS WAS: ■ Causticum 15 CH, ■ Arsenicum album 9 CH, ■ Ipeca 15 CH and ■ Silicea 30 CH, every day; ■ Lycopodium clavatum 30 CH, 1 dose per week; ■ Medorrhinum 30 CH, 1 dose per week.

The evolution was spectacular: the child is reassured, communicates well, no longer has enuresis, the medical examination is completely normal, with a clear improvement of the spasticity and use of her limbs.

ASMA CONTINUED TAKING HOMEOPATHY UP TO THE AGE OF 15: ■ Causticum 15 CH every day and ■ Lycopodium clavatum 30 CH, 1 dose per week.

EVERYDAY

PRACTICE

Colics in infants Martine Tassone-Saillard

C

olics are one of the most common ailments in infants under the age of 3 months. Affecting about 15 to 20% of newborns. causes are not really obvious: immaturity of the intestinal flora, expression of anxiety, there is often an aggravation at dusk and a clear parallel to the parents’ anxiety.

The most important criterion is the regularity of the height and weight curve.

1

How to relieve a baby’s colics?

THE PREGNANCY:

One can propose probiotics, massages, hugs, anti-spasmodic drugs…and homeopathy!

POST-TERM DELIVERY: ■ Pulsatilla 15 or 30 CH, 1 dose

2

How to choose the right medicines?

IF THE MOTHER SMOKED, WITH STRESS DURING ■ Nux vomica 15 or 30 CH, 1 dose ■ Tabacum 15 or 30 CH, 1 dose

FOR C-SECTION EXPERIENCED WITH FRUSTRATION

BY THE MOTHER: ■ Staphysagria 15 CH or 30 CH, 1 dose ■ Opium thebaicum 15 CH or 30 CH, 1 dose It is very important to know the obstetrics history and family context.

ACCORDING TO THE ETIOLOGY ACCORDING TO THE PATIENT INDIVIDUAL REACTION (PIR)

PREGNANCY WITH MULTIPLE TREATMENTS: ■ Thuya occidentalis 15 or 30 CH, 1 dose ■ Nux vomica 15 CH, 1 dose

The symptomatic medicines I use most often are the following:

NUX VOMICA The medicine for spasms, especially when there is constipation, white coating at the back of the tongue and irritability.

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TRAUMATIC DELIVERY: ■ Arnica montana 15 or 30 CH, 1 dose ■ Opium thebaicum 15 or 30 CH, 1 dose

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EVERYDAY

PRACTICE

Colics in infants CHAMOMILLA VULGARIS When very irritable and soothed by rocking.

COLOCYNTHIS Spasmodic pain, improved by flexing the legs on the abdomen, bloating, frequent diarrhea.

DIOSCOREA VILLOSA Improvement in hyperextension.

CUPRUM METALLICUM Violent, short-lasting pain with acute cries, frequent hiccups.

CALCAREA CARBONICA OSTREARUM A florid, stocky baby with large fontanels, prone to cradle cap, diaper rash. Good appetite but can be intolerant to milk. Calm she does not mind the clinical examination, we often find a history of atopy.

SULFUR Most often a big baby, but sometimes not, intolerant to heat, she sweats easily, irritation of the skin folds, redness of the orifices, quite voracious, very sociable, the clinical examination is easy, family history of atopy.

THE “MAGNESIA” TEAM LYCOPODIUM CLAVATUM MAGNESIA PHOSPHORICA Pain is the most acute out of the three medicines, improved by the hyperflexion of the legs on the abdomen, strong pressure, friction, local heat, taking the diaper off;

MAGNESIA CARBONICA Colics with pain bending the newborn in two, greenish, foamy diarrhea with a sour odor, gas, milk intolerance;

This medicine is mostly indicated for a smaller baby with dry skin. She eats often, even at night, there can sometimes be an anorexia: bloated, prone to constipation. Looks at everything in a very serious manner, she can have this aspect described classically as prematurely old.

SILICEA MAGNESIA MURIATICA Colics with constipation, small dry, brittle stools, milk intolerance.

RHEUM Colics with pain bending the newborn in two, brown, sticky diarrhea with a sour odor, sour sweats all over the body, and improvement by heat, the baby refuses her mother’s milk.

THESE MEDICINES ARE GENERALLY USED IN ■ 9 CH or 15 CH by dissolving 10 pellets in 30 to 40 ml of water and giving about 5 ml before each breastfeeding episode.

Hypothropic infant with fine bones, she sweats easily from her head and feet, with a foul odor, gets easily cold. She needs to be awaken and stimulated to breastfeed, prone to constipation, irritable, startled, cries, gets angry when touched.

NUX VOMICA Impatient baby, intolerant to noises, tantrums, takes short naps, very good appetite with frequent hiccups, eructation and prone to constipation.

CALCAREA PHOSPHORICA Tall, lanky baby, with variable appetite, poor tolerance to milk, with diarrheic stools and gas, alternating excitement, agitation periods and waking up at night screaming.

ACCORDING TO THE SENSITIVE TYPE

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MEDORRHINUM

14

For infants, just like adults, one determines the Sensitive Type medicine according to the morphology, behavior and pathological tendencies, the latter are more difficult to appraise according to the infant’s young age, but the obstetrical and family history will be especially important in that context.

IN MY CLINICAL PRACTICE, THE MEDICINES I MOST OFTEN ENCOUNTER ARE:

Agitated newborn with a diaper rash, wants to nurse again after the end of a breastfeeding session, frequent hiccups, eructation and constipation. He won’t fall asleep until one understands he wants to sleep on his abdomen, knees flexed under him, which worries his parents in light of the latest guidelines in terms of safe sleeping positions in infants!

EVERYDAY

PRACTICE

Colics in infants

For infants, just like adults, one determines the Sensitive Type medicine according to the morphology, behavior and pathological tendencies, the latter are more difficult to appraise according to the infant’s young age, but the obstetrical and family history will be especially important in that context.

“

SEPIA OFFICINALIS Hyperlaxity is already visible at the examination.

3

Clinical case ROSE IS A SMALL 15-DAY OLD BABY

Breastfeeding on demand, she almost did not leave the hospital at 5 days of life because she

had not gained back the weight after the physiological birth-related weight loss.

ON THE DAY OF THE EXAMINATION, SHE WEIGHS 3KG She is very slender and looks around her with large eyes, quite precocious for her 2 weeks, very tense, she cries and doesn’t like being touched. The abdomen is bloated but soft to the touch.

Her mother tells me that during her colic episodes she screams, arches her back in hyperextension, nothing relieves her except walking and holding her straight up against her father or mother. She only has one bowel movement per day (which worries the mother).

She does not spit back milk, does not burp after each nursing session.

PROPOSED PRESCRIPTION ■ Arnica montana 30 CH, 1 dose D1 ■ Opium thebaicum 30 CH, 1 dose D2 ■ Abrotanum 9 CH, 1 dose D3 ■ Silicea 15 CH, 5 pellets per day for one month

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Her mother is quite worried, she does not nurse often, we need to wake her up and stimulate her, she will sometimes have awful abdominal pain, and nothing can relieve her.

First eventless pregnancy, very long labor, between exhaustion and the epidural the mother did not have the strength to push further, small birth weight 2 900 g, 46 cm, head circumference 38 cm, Apgar 10/10.

“

15

EVERYDAY

PRACTICE

Colics in infants ■ Dioscorea villosa 9 CH and ■ Chamomilla vulgaris 15 CH, 10 pellets per day of each, to dilute in 30ml of water and give in a baby bottle to be evenly distributed during the day, for a month.

I reassure the mother on breastfeeding and the frequency of the bowel movements that can vary a lot and I give her an appointment the following month to reassess the situation.

COMMENTS

MAY 2017 CEDH MAGAZINE

• Arnica montana and Opium thebaicum were given based on the etiology of a difficult delivery.

• Abrotanum is a dose that helps recover a proper weight.

• In my opinion, Silicea seems to be her Sensitive Type.

• Dioscorea villosa and Chamomilla vulgaris are medicines for colics corresponding to the Patient Individual Reaction. ■

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HISTORY & CULTURE

The clinical homeopathy of Dr Beauvais de Saint-Gratien Who were the precursors of homeopathy?

DrJean-François Becker & Dr Franck Choffrut

I

t is not essential to have read “An inquiry into the causes and effects of the variolae vaccinae“ by Dr Edward Jenner to inject a dose of vaccine. Furthermore, the prescription of a pellet tube does not require the prior reading of Hahnemann’s work.

However, if physicians did not testify, in their written work, about the effectiveness of

a reasonable and reasoned vaccination (and Hahnemann was one of its advocates), it would have disappeared under the battering of its detractors. Having studied for two years the Clinical Homeopathy by de Beauvais de Saint-Gratien we realized is was a great testimony to the beginning of homeopathic practice but it also shed a specific highlight on the various problems of today’s modern homeopathy. We propose to share with you this knowledge.

First, we will focus on the very first appearance of homeopathy in Europe.

1

The Clinical homeopathy

The Clinical homeopathy or collection of all practical observations published to date1 was published, in Baillière, between 1836 and 1840 by Beauvais (de Saint-Gratien).

The title already gives an indication on the goal set by its author: “Clinical” was not chosen haphazardly: at the time of its publication, this term “refers to physician who visit patients, in opposition to those who consult and those who write2”. It is above all a practical book.

IT IS MADE OF NINE VOLUMES: - Volume I: Mental alienation (1) - Cephalgia (448); - Volume II: Cephalgia (449) – Acute enteritis (1071); - Volume III: Acute enteritis (1072) – Typhoid fever (1664); 1 2

Beauvais (de Saint-Gratien), Clinique homoeopathique, Baillière, 1836-1840 (google-books).

Dictionnaire de l’Académie Française, sixième édition, Firmin Didot, 1835, p. 330 (gallica).

HISTORY

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The clinical homeopathy of Dr Beauvais de Saint-Gratien. The precursors of homeopathy - Volume IV: Typhoid fever (1665) - Hysteria (2160); - Volume V: Hysteria (2161) - Ophthalmia (2726); - Volume VI: Ophthalmia (2727) - Pneumonia (3214); - Volume VII: Pneumonia (3215) - Syphilis (3758); - Volume VIII: Syphilis (3579) – Herpes zoster (4439); - Volume IX: Adenitis (9/1) - Vomiting (9/700) and an alphabetical table of medicines used.

THESE 5 140 OBSERVATIONS transcribe the consultations that physicians (Europeans or from European origin) made between 1816 and 1838.

Two types of observation, general (“in this pathology, I used…”) and specific ones (“in this patient, I used…”) and were collected from different medical journals and books (in German, French and Italian) and translated, their titles, as too often in the homeopathic literature of that time, were quite fragmented. This is even more paradoxical as these writings were one of the first means of disseminating the information on Homeopathy.

13 This is why we do not really understand why the author published under a pseudonym. It was in fact, Dr. David Roth (1800-1885), born in Budapest who came to Paris after having obtained his Doctor of Medicine diploma in Vienna, and was initiated to homeopathy by Antoine Pétroz (1781-1859) who was one of the book’s dedicatees. Roth corresponded regularly with Hahnemann, translated several homeopathic books and was involved in several French Journals3. The fact that he chose a pseudonym might be because he published one of his own observations4.

Taking into account that he translated into a language that was not his mother tongue, Roth was a very good translator. Only the use of the term “rognon” (animal kidneys used for cooking) in an urology observation5

Antoine Pétroz (1781-1859), pioneer of homeopathy in France, contemporary of Hahnemann in Paris and one of the dedicatees of the Clinical Homeopathy book

1

Hahnemann surrounded by his students. Up top: Picture of Antoine Pétroz

could make one smile. Even though he did often misspell their names (as was customary at the time in homeopathic writings), he respected the content of the authors’ writings (which was quite rare at the time) but did not hesitate to let them take their responsibility when their diagnoses were a bit fanciful.

This collection, published by an editor specialized in the publication of homeopathic studies, is a fascinating source full of information on the clinical practice of homeopaths during the expansion of this new therapeutic method. Roth underlined this: “We repeat once again that we list diseases as we found them, without worrying if the diagnosis was accurate or not (sic), if the disease did in fact regress thanks to the remedy or if it was conquered 3

Rabanes O., Sarembaud A., Dictionnaire des auteurs d’ouvrages d’homéopathie, Boiron, 2003. obs. Syphilis (sycose), 3871.

5 obs. Rétention d’urines, 3326, Attomyr.

6 Beauvais (de Saint -Gratien), Clinique homoeopathique, op. cit., t. 3, p. 6.

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HISTORY

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The clinical homeopathy of Dr Beauvais de Saint-Gratien. The precursors of homeopathy

9 3 6

Onset and development of homeopathy in Europe from 1816 to 183

7 4

5

H

The first testimonials on homeopathy's appearance in Europe between 1816 and 1838 1 : 1816 2: 1819 3: 1821 4: 1822 5: 1824 6: 1826 7: 1827 8: 1832 9: 1833

10: 1834 11: 1835 12: 1837 13: 1839

1 2 8 11 10

5 12 4

by the forces of nature. All this is outside of the rim of our current research. (…) Thus, we persist in our principle to show the naked truth, lay it out without choosing and classifying what we find under a specific disease; because it is the only way to get a positive result. Knowing all that is wrong and useless in homeopathy might be a way to see in a brighter light the full truth of this doctrine6”.

A reliable book by various authors on the evolution of homeopathy in their own country

As one notices on the figure below, the development of homeopathy was not harmoniously concentric and it is interesting to study in depth who were the players, and what were the vectors and conditions of its expansion.

A NON-PHYSICIAN It was probably a profane (as one, in German-speaking countries, addressed the non-physicians interested in homeopathy) who really pushed for the development of this new school of medical thinking. Benito Iriarte left his natal Andalusia to go to Köthen and Lyon to be treated by Hahnemann and the Count Des Guidi.

He disseminated in Spain Hahnemann’s books in the French version.

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The first testimonials on Homeopathy’s appearance in Europe between 1816 and 1838

that yielded precious information7.

When reading it, we immediately realized that homeopathy did not necessarily spread because of the linguistic proximity or direct and early knowledge of Hahnemann’s founding texts.

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HISTORY

& CULTURE

The clinical homeopathy of Dr Beauvais de Saint-Gratien. The precursors of homeopathy A PRECURSOR PHYSICIAN In 1821 in Denmark, Hans Christian Lund (17651846), a navy physician, was the first one to practice homeopathy. He seemed not to have been aware of this new therapeutic method by the first homeopathic publications in Dutch, since they were only published one year after the beginning of his clinical practice.

Maybe he heard about homeopathy on one of his navy trips?

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The introduction of homeopathy in Poland, in 1822, is interesting because it is the first testimonial on the introduction of the new method by a foreign physician: the French military surgeon and physician GérardJoseph Bigel (1769-1854) who learned homeopathy in Dresde and became the personal physician of the Grand Duke Konstantin Konstantinovich, governor of the conquered Poland appointed by the Russian Tsar.

Again foreign physicians introduced Homeopathy in the two States of today’s Italy: the Count Sébastien Des Guidi (1769-1863), a physician from Napoli who moved to Lyon after having fled the Bourbon Restoration, started to promote it in 1835 in PiémontSardaigne. The Neapolitan physicians Francesco Romani (1785-1852) and Cosmo Maria de Horatiis (1771-1850) gathered a group of Roman physicians but it is only during the Cholera pandemic of 1837 that the first Homeopathic Pharmacy of the Papal state was founded.

In spite of a flexible legislation (physicians are allowed to manufacture their own medicines) we only

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find the first report on homeopathy quite late in Switzerland. Charles-Gaspard Peschier (1782-1853) seems to have introduced homeopathy around the year 1832. He helped with the training of a homeopathic hospital in Leipzig, and wrote several books to popularize homeopathy

ONE PHYSICIAN AND THE KNOWLEDGE OF FUNDAMENTAL WRITINGS. In 1816, the physician and surgeon of the Prague’s Chief of Staff (under Austrian ruling), Matthias Marenzeller (1765-1854), studied homeopathy after having read in a scientific journal the “Review on the new therapeutic method of Samuel Hahnemann8”.

He was not the only physician to look at homeopathy in a pragmatic way. Jacques Léonard found the trace of an epidemiologist in Saint-Brieuc, France who was interested in it, right from 1819, after having read an article on the efficacy of homeopathy on scarlet fever9.

If military physicians seem to have had a major influence during the first years of homeopathy’s dissemination, it was probably due to the fact that several years of Napoleon’s wars did in fact lead to major advances in surgery, but also motivated

HISTORY

& CULTURE

The clinical homeopathy of Dr Beauvais de Saint-Gratien. The precursors of homeopathy military physicians to look for cost-effective ways to ensure the good health of the soldiers. Not only did these wars cause thousands of deaths, along with surgical and medical advances, they also, as noted by Hahnemann, promoted a national conscience.

“People like the German, who throughout the centuries dropped into passive apathy and bonded slavery, first had to be trampled into the dust by a western tyrant up to ten years ago when they could no longer take it. It was only in that way that their lack of self-esteem was dominated and erased. They felt again their dignity as human beings and raised their heads for the first time as German men and free men” (in 5 § 26n).

All Neapolitans were not pleased when the Bourbons claimed back the throne of the Two-Sicilies. Ferdinand the First asked the Austrian troops for help, which arrived in Naples with weapons and luggage. In their luggage, the Materia Medica Pura given by an Austrian general to the Bourbons’ army to be translated. If the Academy sent in 1822 the military physician Jürgen von Schönberg (1782-1841) to Köthen to learn homeopathy’s fundamentals, it is really the physician Georg Necher (1770 ?-1818 ?), born in Bohemia and personal physician to the Austrian Chief of Staff, who was responsible for introducing the new doctrine. He settled in Naples, learned

Italian and founded a homeopathic clinic and thus disseminated homeopathy among Neapolitan physicians.

It is once again de Horiatis, personal physician to the king Francis I of the Two Sicilies, trained by Necher, who introduced homeopathy to the Spanish court.

However his influence remained limited and so brief that one could consider it quite marginal., The presence of homeopathy in Romania, during the Turkish occupation is due to one of Hahnemann’ student Johann Honigberger (1794-1869), born in Brasov (region where Hahnemann spent 20 months as a personal physician and librarian to the Baron von Brukenthal). However, he only seemed to have practiced only sporadically in today’s city of Iași before leaving for India.

One last example of the introduction of the new doctrine by physicians: the United Kingdom where, in 1826 the London Medical Society proposed a presentation on the “The new medical method by Dr. Halnemann (sic)”.

THE FOUNDING TEXTS FIRST In today’s Belgium, the first sign of Hahnemann’s ideas was the dissemination (in 1824) of the first French translation of the Organon (1st edition by Von Brunnow). However, according to historians, it is the surgeon from Aalst, Pierre Joseph de Moor (17781845) who was considered the precursor of homeopathy.

In The Netherlands, it is again a translation of the

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Some of homeopathy precursors in Europe (From left to right): Count Sébastien Des Guidi (1769-1863), Francesco Romani (1785-1852), Matthias Marenzeller (1765-1854), Johann Honigberger (1794-1869), Gerard Suringar and Cosmo Maria de Horatiis (1771-1850).

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HISTORY

& CULTURE

The clinical homeopathy of Dr Beauvais de Saint-Gratien. The precursors of homeopathy Organon (3rd edition), in 1827, which triggered a reaction of a physician from Leiden, Gerard Suringar. He listed its advantages and drawbacks. It is the beginning of a polemic on the need for this new doctrine.

The proselytism of homeopaths “Gaetano Delfrate, a 12-year-old boy, robust, fat, very muscular, trained early on in gymnastics, had a heart attack during a stay in Marseille, which consisted of an inflammation of the heart treated by allopathy. (…) Eager to spread Hahnemann’s doctrine, I decided to invite several physicians to conduct a consultation, listen to their opinions and prepare in their presence homeopathic remedies. I invited two of them to come.

One of them made some difficulties, but he ended up saying that the disease was an incurable organic defect of the heart, and that dropsy or consumption would be the end of the patient. Since Spigelia offered symptoms very similar to the disease, I decided to administer some globules in 30. The physician whom I just talked about, thought it would not do anything and refused to administer it, however Doctor Trasmundi thought that such a small quantity could not harm, however he asked to watch the preparation. As I wanted several physicians to witness this new cure, I invited other doctors such as

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The Vienna Academy of Medicine where the young Hahnemann studied

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Lomonaco, de Mateis and de Crollis, to come and see the patient. The first did not talk much and said nothing could be done. The second said that the disease was a fixed nodule, the third said that it was a vegetating growth, and Dr. Trasmundi said it was aortic aneurysm or a polyp growth. All agreed that it could not be cured and that an ordinary treatment could only improve slightly the patient’s desperate state.

The child’s father, seeing that these physicians could not save his son, trusted me with his cure, in spite of their sarcasms and mocking.

Trasmundi wished to be there when I prepared and administered the medicines in order to see with his own eyes their effectiveness. (…) On February 1st, I administered Spigelia 3/30.

Trasmundi and the child’s father started laughing and thought it was only to prepare the patient to receive stronger doses. (…) Five days later, I met Dr. Trasmundi at the patient’s parents’ house and he agreed that the improvement was clearly obvious10”.

The transmission of homeopathy’s knowledge can be by direct contact between a homeopathic physician and his colleagues, or by disseminating the fundamental homeopathic books. And it was successful as evidenced by those who became homeopaths: Des Guidi treated one of Gueyrard’s patients, when he was still an allopath physician.

HISTORY

& CULTURE

The clinical homeopathy of Dr Beauvais de Saint-Gratien. The precursors of homeopathy

The new doctrine introduced in the United Kingdom by physicians of the London Medical Society

Two months of treatment with Belladonna, Pulsatilla and Platina treated a schirrus of the matrix. “Dr. Gueyrard told me himself that this type of cure was the reason he converted to homeopathy11”.

Duplat, a physician from Marseilles, did consultations along with his medical students Nanguis and Pascal12. Widenhorn differentiated, in his observations, what he called the local affection and sympathic affections (what we would call nowadays the concomitant symptoms). He justified this distinction as such: “It is with intent that in these three observations, I differentiated the local affection from the sympathic affections.

This method can spare a lot of embarrassment to beginners, in examining the patient and looking for the medicine13”.

Arguments are not solely limited to the effectiveness of homeopathic medicines since financial considerations were also brought

While speaking to her, I had prepared a dose of bellad.

30, I gave it to her and she swallowed it without hesitation, I prescribed sugary water as the only drinks.

It was as time when Homeopathy started to become quite common in Lyon, which was quite exciting for some and terrifying for others, my patient was one of the antagonists. (…) My recovering patient became aware that it was possible to decrease the blood’s effervescence, without depriving the body from this precious fluid, however she was scared when she learned that she took homeopathy. It took me a while to calm her down, because another physician she knew and who pretended to know the new remedies without having experienced them in his practice, told her that a patient who took homeopathy could indeed heal, in quite a spectacular manner, but it was at the expense of the time the person had left to live, in a word that a year would not go by before the patient would die from a slow poison15”.

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This proselytism was not only directed to physicians. It also concerned pharmacists and patients: who were essential partners.

Gueyrard treated an inflammation of the tonsils “in a 30-year-old Lyon pharmacist, strong, blond and well built” with “a dose of belladonne. (…) Incredulous the day before, this pharmacists as since dedicated his life to preparing homeopathic remedies14”.

forward. Homeopaths look to overcome biases, incredulity and reticence, not only from healthcare professionals who are not homeopaths but also patients. “A 42-year-old strong, fat and plethoric woman, who was in the habit of having large and frequent bleedings, was prone to violent blood congestion to the head, eyes, inflammatory congestion of the limbs, erysipelas, etc. (…) On February 15, 1831, I did a large phlebotomy. (…) “I bled you a few days ago, I told the patient, it is starting to become too much: take this first and if tomorrow you are not better, there will still be time to proceed with the bleeding.”

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HISTORY

& CULTURE

The clinical homeopathy of Dr Beauvais de Saint-Gratien. The precursors of homeopathy The founding father Samel Hahnemann, the stamp dedicated to his work in 1996 in Germany celebrating the bicentennial of homeopathy and the Organon

“These precursors did in fact play a great role, but how was this message received and accepted? This will be covered in the next article.“ ■

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Jean-François Becker & Franck Choffrut

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7

Dinges M., Weltgeschichte der Homöopathie, C.H. Beck München, 1996.

Dinges M., Weltgeschichte der Homöopathie, op. cit., p. 78.

9 Dinges M., Weltgeschichte der Homöopathie, op. cit., p. 49 n.

10 obs. Cardite, 131, Mauro.

11 obs. Cancer, 382.

12 obs. Choléra épidémique 556, 557, 560.

13 obs. Hémorroïdes, 2017.

14 obs. Amygdalite, 134.

15 obs. Érysipèle, 1272, Gueyrard.

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MATERIA

MEDICA

Kalium iodatum Dr Josette Nouguez

1

P

otassium iodide has a toxicology similarly to mercury with: 1. Catarrhal inflammation of the ocular, ENT, digestive and lung mucous membranes; 2. Edema of these mucous membranes; 3. Adenopathies; 4. Osteoperiostitis; 5. Ulcerations

Pathogenic targets ENT AND OCULAR SYSTEMS:

2

Patient Individual Reaction (PIR)

IRRITATION OF THE NASAL MUCOSA WITH:

SENSATIONS

• sensation of constriction at the root of the nose, redness and edema of the nose, • burning, watery and profuse coryza with sneezing and eye watering at the beginning, • then mucopurulent, greenish and foul-smelling discharge;

• Constrictive pain at the root of the nose; • Shooting pain over the left orbit, in the upper maxillary; • Nighttime, drilling, bone pain.

PHARYNGEAL AND LARYNGEAL INFLAMMATION: • edema of the uvula and the larynx;

INFLAMMATION OF THE SINUS MUCOSA: • pain in the frontal sinuses;

OCULAR INFLAMMATION: • conjunctivitis with irritating eye watering.

• Pain aggravated at night, need to move; • Localizations: nape of the neck, back, knees, sole of the feel, heels.

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RHEUMATOLOGY

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MATERIA

MEDICA

Kalium iodatum MODALITIES • aggravation: by heat except coryza, at night; • Improvement: by fresh air, except coryza.

CONCOMITANT SIGNS • Watery discharges that become thick, abundant and sometimes greenish.

3

As clinical indications in children • acute coryza; • allergic rhinitis with watery, burning rhinorrhea; • acute frontal sinusitis; • subacute laryngitis with dysphonia and edema.

OPHTHALMIC SYSTEM • allergic or infectious conjunctivitis.

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• Kalium iodatum, close to Mercurius solubilis in its toxicology and targets, will be a central medicine in the treatment of rhinopharyngitis and sinusitis.

• Like Mercurius, it will be prescribed from the watery to the mucopurulent stage.

It conjugates inflammation, edema, irritating discharge.

we will keep in mind:

ENT SYSTEM

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4

Personal observation

• It can be compared to Kalium bichromicum, which is only indicated in the mucopurulent stage with ulcerations and crusts of the nasal fossa. For a reliable prescription, it is essential to find the symptom: “puncture-like pain”. ■

MATERIA

MEDICA

2 I

Causticum The patient’s individual reaction and sensitive type at all ages

Dr Josette Nouguez

n a previous article we looked at the relevance of Causticum in pathologies of the respiratory and digestive mucous membranes as well as urinary and anal sphincters in children. In this article we will look at the other pathogenic targets of Causticum and their pathological expressions throughout one’s life.

JUST LIKE IN CHILDREN, WE WILL FIND THE FOLLOWING ETIOLOGIES: • Psychological trauma: following traumatic fear, vexation, long-lasting sorrow, insomnia: • Following muscular overexertion; • Following spinal cord injuries, hemiplegia.

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Skin “skin growths, dermatitis with fissures and oozing”

AN ESSENTIAL MODALITY WILL BE ASSOCIATED TO ALL THESE PATHOLOGIES:

• WARTS that will take two aspects according to their localization: - Large, horny, pedunculated or serrated warts that bleed easily, located on the extremities of the fingers, periungual or subungual warts, but also plantar warts, - Flat warts when located on the nose, eyelids, forehead, lips;

• Aggravation by dry cold; • Improvement by heat, especially damp heat.

• OLD KELOID, HYPERTROPHIC, PRURITIC SCARS or scars that become painful again with sensation of raw skin, consecutive to an old burn;

“burning, sensation of scraping, tearing pain”.

Affections of the digestive and respiratory mucous membranes were seen in the previous article; we can see an affection of the gynecological mucosa with the same characteristics, especially following chemotherapy.

• HARD, DEFORMED NAILS with paroxysmal pain, sensation of a raw wound, scrapes and burns (following chemotherapy); • DERMATITIS HERPETIFORMIS or vesicular and pustular dermatitis: oozing eczema behind the ears with whitish exudation;

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Mucous membranes

• ATROPHIC DERMATITIS with fissures located on the scalp, behind the ears, on the corners of the lips, skin folds, nipples, and heels.

Intertrigo with fissures, painful on dry skin;

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MATERIA

MEDICA

Causticum: The patient’s individual reaction and sensitive type at all ages • GENERALIZED OR LOCALIZED PRURITUS, improved when scratching: senile pruritus.

3

The osteoarticular system “stiffness, retractions”

ITS ACTION IS QUITE NOTICEABLE ON LARGE JOINTS

• ANKYLOSIS AND DEFORMATION: arthritic pain and painful stiffness of the spinal cord and lower back, cervicobrachial neuralgia; • TENDON RETRACTIONS, especially the flexors: tendinitis with sensations that tendons are too short (palmar aponeurosis, carpal tunnel). The patient walks on the tip of his toes, unable to put the heel down if the affection concerns the Achilles’ tendons; • HIP JOINT PAIN, like a dislocation; • MUSCLE SPASMS with muscle weakness: Hand dystonia (writer's cramp); • SCIATICA with motor impairments and muscle wasting.

Neurological sequelae after herniated disc if the patient retains some motor impairments.

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The central and peripheral nervous systems: “paralysis, paresis” more or less located in one single area

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• “A FRIGORE” FACIAL PARALYSIS or ptosis after being exposed to dry cold. This paralysis tends to settle down and become chronic;

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• PTOSIS AFTER OPHTHALMIC herpes zoster associated with burning paresthesia and local numbing.

The eyelids are so heavy that the person can barely lift them. Sometimes the ptosis is associated with a sensation of cloudy vision, like a veil is in front of one’s eyes; • OCULOMOTOR NERVE PALSY, with burning, irritating, ulcerating eye watering; • PARALYSIS OF THE EYE MUSCLES, diplopia;

• TONGUE PARALYSIS: dysarthria, stuttering, awkward speech, bites his teeth and tongue; • PARESIS OF THE SOFT PALATE; • COMPLETE PARALYSIS OF THE PHARYNX AND ESOPHAGUS: choking and swallowing disorders, sensation that the “throat” is too tight, constant need to swallow; • ANAL SPHINCTER PARESIS: - with constipation, frequent but useless urges to go to the stool, violent efforts, redness of the face. The patient can only have a bowel movement when standing up, - fecal incontinence due to a loss of sensitivity; • PERIPHERAL PARALYSIS IN ISOLATED AREAS (face, larynx, sphincters), always associated to a sensation of weakness, shaking, loss of strength. Sequelae of recent hemiplegia or spinal cord trauma (herniated disc…); • PARALYSIS OR PARESIS OF THE VOCAL CORD with hoarseness: - Either from a viral origin, - After vocal exertion, - Or post-traumatic (tracheal tube), surgery; • SPHINCTER AND/OR BLADDER PARALYSIS OR PARESIS: - Either paralysis of the bladder muscle with urine retention, - or affection of the urethral sphincter and bladder incontinence, - bladder retention after exertion of the urinary tract muscles and getting cold, - bladder incontinence when coughing too hard, - childhood enuresis; • CHARACTERISTIC DYSESTHESIA made of burning, violent, numbing pain, staying in the same place for a long time; • CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY; • PARALYSIS AFTER BLINDING, CONGESTIVE, POUNDING HEADACHES; • PARALYSIS OF THE LIMBS, especially the lower limbs, with great weariness, muscle ptosis, heaviness in the body, major fatigue.

MATERIA

MEDICA

Causticum: The patient’s individual reaction and sensitive type at all ages

5

Sensitive type of the aging adult THE ADULT WITH THE CAUSTICUM SENSITIVE TYPE WILL PRESENT WITH:

PATHOLOGIES seen previously with characteristic etiologies;

6

In conclusion We can say that Causticum is an important medicine throughout our patients’ lives both on a physical and behavioral level.

THE SIGNS OF THE SENSITIVE TYPE WILL BE OBSERVED VERY CLEARLY AT BOTH THE BEGINNING AND END OF ONE’S LIFE.

A SPECIFIC MORPHOLOGY: • Generally, lean, thin, weak persons, sensitive to dry cold, • Sickly, pale and yellowish complexion, • Often ptosis of the upper lids, • Whitish lines at the rim of the lower lip;

• CHILDREN, as seen in the previous article; • AGING ADULT with an evolution towards senescence. Retraction, stiffness as well as physical and intellectual regression predominate, it is the progression to senescence. ■

WHAT STRIKES US, IS THE STIFFNESS WITH ANKYLOSIS, RETRACTIONS AND PHYSICAL REGRESSION.

A SPECIFIC BEHAVIOR: • Intellectual weakness, • Memory loss with confusion of letters or syllables when speaking, • Dominant depression, sadness following worries, sorrows, moral shocks, • Distant, wary with his closed ones, • Irritable, mean, reluctant, contrary, and wary, argues a lot, • Quite capable of empathy for suffering in others, • Great anxiety fostered by an imminent sense of doom, • Feeling of guilt alternating with irritability, anger tantrums for small things, • Feeling that something dreadful will happen, • Unable to work, progresses towards feeblemindedness, • Fear of death, of being alone, dreading the nightfall, • Afraid of darkness, frightening hallucinations when closing his eyes.

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ON A BEHAVIORAL LEVEL WE WILL FIND, SIMILARLY TO THE MORPHOLOGY, AN AGING SUBJECT WHO, AFTER SEVERAL ETIOLOGIES, WILL PRESENT WITH: STIFFNESS, RETRACTIONS, REGRESSIONS.

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MATERIA

MEDICA

Mercurius cyanatus Dr Josette Nouguez

T

his toxic substance has been used for a long time as an antiseptic and antiepileptic.

1

Pathogenic Target Only one pathogenic target was found in the pathogenic experiments, it is the ENT system.

GENERAL ACTION • peracute inflammation with ulcerations, grayish, sticky, thick false membranes; • quick-setting and deep prostration; • major, painful, satellite adenopathies; • intense dysphagia.

CLINICAL INDICATIONS

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• non-streptococcal, erythematous-pultaceous sore throat with grayish false membranes, adenopathies, dysphagia, affection of the general state. Before, the diphtheria vaccine, it was the “specific medicine” of this pathology; • oral canker sores with false membranes.

2

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Personal observation

Mercurius cyanatus is a very effective medicine in frequently encountered viral sore throats which, by their aspect, are impressive to the physician and patient.

It is important to prescribe it as a “sentinel medicine” right from the inflammatory state, right from the onset of pain without waiting for the false membranes to appear. ■