A Ball of Fire

Monday, October 18th, 2010

Franklin had called the college clinic quite a number of times. Desperation is hard to watch. Rachel at the front desk patiently encouraged him to give homeopathy a try. “It won’t hurt” she would patiently repeat.

Hesitation acquires a tormenting life all it’s own. It was new and unknown territory. On the one hand that’s what it was going to take to solve this conundrum. A leap to a new paradigm. On the other hand conventional tried and true wisdom had only served to make the issue more intolerable and promised a life of misery. What would this voodoo inflict in the way of unwanted sequelae?

Finally and with an enormous degree of trepidation he did book. I imagine the final lure was the old “primum non nocere “ of homeopathic treatment. The first law of medicine we inherit from Hippocrates-first do no harm. Where conventional medicine has a love affair with toxic doses homeopathy deals with infinitesimals.

Homeopathy is predicated on matching a profile of sensitivities so exquisitely that a mere exposure to the ghost of a substance will propel the system towards a dynamic self healing-the Holy Grail of medicine.

Lets get real. No sane patient will swallow that one too easily. Common sense tells us that the enormous machinery of conventional medicine would’ve caught on to that one if it were legitimate. So why trust a quack? Only because of limited options and this one is at hand. Anyway I was referred to him by a previous patient-one more push.

Franklin was suffering a severe prostatitis. It had been over a year,3 specialists and many rounds of antibiotics. The net result-it was now chronic. At least the labels had changed.

One evening just over a year ago he began to acutely experience a rather unpleasant sensation. “It was as if a large object was inserted into my crotch”. It stayed like that for 3 months. Drugs had no effect.

“Now it is chronic and the last seven weeks I have this severe lower back pain. It is all unbearable. However I am optimistic.”

I hate to admit this but over my many years of practice I have not had more than a half dozen cases of prostatitis and none of them had any very peculiar symptoms in the syndrome itself. So of those I was able to be effective with the remedy was determined by closely questioning for peculiarities in the chronic state. This one was to be a very different sort of challenge.

On being prompted to describe the discomfort there was no delay in launching into a richly descriptive outburst.

“Where my prostate is—it feels like there is a tennis ball there and it is on fire! After having sex there is a pulling tension in the urethra. In my coccyx there is a cold numb pressure. It’s there twenty four-seven.”

Now on questioning a bit more this pulling was a pain that extended backward along the urethra into the abdomen.

I often have trouble writing quickly enough to keep up with these narratives but this time I made it to the end without asking for a repeat of the story.

Hot Epsom salt sitzbaths relieved coccygeal pain briefly.

The pain interrupted sleep. He would wake at 5 am and be very unrefreshed. Going right back to sleep he would finally be up for the day at 8am.

The urinary stream was interrupted.

Our patient had been involved in a bad motor vehicle accident about 2 years ago. He described his problem as a severe closed head injury to the lower brainstem. There was as well chronic pain in the right wrist and the cervical spine.

Short term memory loss was experienced.

Headaches were also on the menu. Mostly at the vertex with a feeling as if worms were in the head. The headaches were severe and accompanied by vomiting. They were now less frequent than before but still a horrible and frequent imposition.

“I am just not the same person as before.” This was clear to him when reading or attempting to multitask in some way. It just didn’t happen smoothly or well.

“The first two months after the injury I could not feed or bath myself…after the injury I had major anxiety attacks.”

He reflected on his state for a bit and it seemed to trigger other associations.

“I do have a history of depression. I was unmotivated and there was inertia. Both these episodes occurred after breakups.

He describes himself in relationship as a caregiver.

There is an aversion to the cold weather.

A small decline in energy at 1 pm.

Overall what struck me most a characteristic (after all this search is our principal job as a homeopath) was the symptomatology around the chief complaint.

1. The burning ball. I chose to use the rubric under inflammation here as opposed to just burning pain. Inflammation of the prostate.

2. The pain extending backward. Her I used the rubric Urethra; pain extending backward.,

The most satisfying read was found (as is so often the case) in Hering’s Guiding Symptoms;

Burning smarting in urethra, from meatus backward, posteriorly stitching while urinating.

Urethra feels inflamed and sore to touch, along its whole length, during erections tensive pain, feels drawn up into knots.

Pain extending from orifice of urethra backward, burning-biting, posteriorly more sticking, while urinating.

The remedy was Cann. Sativa 200. One dose

First follow up-2 weeks later.

The patient complains of stomachaches. The pain is described as pulling with sensations of bubbling and gurgling.

The coccygeal pain is still present and perhaps reduced. Now more described as a pressure (the discomfort is less sharply defined).

With an erection there is still a pain in the penis that seems to go backward into the abdomen. There is as well a new pain and severe pain at the root of the penis after ejaculation. This pain seems to radiate everywhere. This radiation is also a new feature and quite striking indeed.

The urinary flow is still restricted.

Stools seem soft. This is an artifact of the last antibiotic.

The fiery tennis ball sensation has much improved but is still there. (I had to specifically inquire about it-he had forgotten).

Assessment.

There have been some improvements and some new symptoms appearing. The Key symptom, which led me to the remedy, has not really improved dramatically. The pain extending backward is perhaps better but not satisfyingly so. There is a new wrinkle to it, in fact most strikingly the radiation aspect.

I feel the remedy has been a simile and not a simillimum. I need a new remedy that has the old symptom and the new wrinkle ideally.

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The radiating aspect was quite striking. I know that Berberis is clinically very important for that idea of radiating pain. There really is nothing in the way of mental or general substantiation for the Argentum.

Plan; Berberis 200, one dose. Repeat if necessary for the pain.

Follow up number 2 (one month later).

The prostatic issue is gone! No pulling, no burning and I sleep the entire night.

My stomach is not nearly as acidic.

I do however have some intense allergic symptoms right now. They seem worse than usual. Burning eyes and nasal obstruction. Phlegm in the chest and for 3 weeks a cough. The cough is worse at night and after exertion out of doors.

The patient has been tired and what is peculiar has been getting hot flushes!

Plan. Burning sensation. Hot flushes with weakness. After clearing a large portion of a chronic case. Sulphur 200. Repeat if it acts and the hot flushes or other symptoms return.

Follow up 3-2months later.

“No stomach issues. No prostate issues or sleep problems. No allergy, cough or hot flushes. No headaches and my functioning seems improved. Not only is it all gone I seem to be steadily improving in health.

I cannot recall a time I have been healthier. My skin is radiant. This was my last chance to get well.”

So let’s look back at this process. I chose a remedy based solely on the most characteristic presentation and verifying it with reliable old literature.

I then complemented the remedy based on newly presenting characteristic symptoms and remaining old (as Hering recommended).

I was able with some degree of precision to proceed because of some good proving information recorded a long time ago.

I used a strictly scientific process. No speculations. Just the Law of Similars.

There are so called schools of Naturopathy out there whose students this article will be inaccessible to because their fragmented homeopathic programs are almost entirely inclined towards “newer authors”.

These students, so disadvantaged, have no significant knowledge of the older literature or the use of homeopathic resources. They are “cut off” from the source.

They take trips to India but they have never acquired the needed basic skills to practice even reasonable first aid homeopathy. In fact they do not really know what the subject actually is. This should concern us all.

These students can pass board exams thanks to specific preparation but are in fact homeopathically illiterate. They have no idea regarding the most holistic of their “modalities”.

The teachers who stand steadfastly behind this new approach call it “advanced thinking” or refer to Hahnemannian studies as “inferior”. They claim- but offer no proof. Why have our schools become an outlet mall for whoever is “hot” on the seminar circuit when the vital basics of a discipline are not at all mastered?

I have no problem with this new approach being taught but please do not call it homeopathy. It is not inductive. It has nothing to do with the Organon. It seems like a re-branded return to the doctrine of signatures and so is more alchemical than homeopathic. Its admixture to a homeopathic curriculum seems to only confuse students.

Ultimately conscientious doctors might abandon their most useful treatment option. Is this what we want for the future of our profession? I believe our students and the public deserves better.