2.15 Nitrogenium, Case 1A 50 year old woman has pains in her joints and hot flushes. Her hands are getting stiff and rigid. She worries about it a lot; she is getting obsessed by what will happen to her hands. She had an operation to scrape away some calcium deposits in the proximal interphalangeal joint of her left ring finger, but the pain returned in the same place in her right index finger. She has stitching pains in the ball of her right thumb, radiating to the thumb itself. Her hands occasionally swell up and turn purple, with pulsating pains. The pains are aggravated by cold and damp and letting her hands hang down.
The menopause started a few years ago with profuse bleeding that went on for weeks. It turned out that she had a myoma in the uterus. This is when the hot flushes started too, with perspiration mainly on the back and a pricking feeling as of needles in her arms. The hot flushes are worse at night, from 3 am till the time she gets up, also worse after urination. She has a general feeling of tension all over her body. It is making her ‘mad’ and irritable. She found that hormone pills help with the hot flushes but they make her feel sick.
The problems became worse after her mother and her mother-in-law died. Shortly after that her youngest daughter left home and she felt the house was too empty without her.
She is afraid of heights, spiders, frogs, narrow spaces, tunnels and caves (3), also of snakes and of being out in town at night. She is an open and uncomplicated type of woman. She says she is easy going but she does like things to go her way, according to her husband and children. When a job needs to be done in the house, for instance a door that needs repainting, she can go on and on at her husband because she wants him to start straight away. She does worry about finances, particularly whether they will be able to afford to let their two children go to university. These worries started several years ago when her husband was made redundant. They took the company to court and he was consequently reinstated.
She ‘flies off the handle’ when someone says something wrong. She gets irritable when things aren’t done fast enough. She tends to be a ‘worrier’.
Her husband says that she is easily offended, especially when someone criticises her housework. After her outburst she wants to make it up again. She feels ‘I really do my best all the time’. She says that her self confidence isn’t as great as it looks.
She feels very close to her family, especially to her mother. In the first year after she got married she still spent 4 days a week at her parents’ house.
She feels hurried when it is windy outside.
During the homoeopathic treatment she started to suffer from arrhythmia of the heart. She woke up at 1 am with terrible palpitations and pains in her chest, radiating to both arms. Her fingers were tingling and perspiration was gushing down her face. She felt as if something was stuck in her oesophagus and she couldn’t get it to go down. She had to sit up straight because lying down made her feel as if she would suffocate. She got very frightened and was taken to hospital where they diagnosed an ectopic heart rhythm.
She often dreams about her mother and about parties.
Sometimes she has a heavy, nagging, upsetting pain in her abdomen, with much rumbling and aggravation from pressure. She once had diarrhoea that was yellow, burning and sour and it went on for two whole days. It made her feel very weak and nauseous.
Her gallbladder was removed because of gallstones. This was discovered after she had been very ill with fever and turbid, dark yellow urine. She often had nephritis in the past.
She has had two miscarriages. When she was expecting her first daughter she lost some blood in the 1st week. After the birth of her second daughter she kept bleeding for a long time. She did not have enough milk to breast-feed her babies.
GeneralsWeather: warm, < warmth; < cold, < damp; < wind (3).
Perspiration: little.
Time: < 1,3-5 am and after 3 pm.
Desires: bread (3), sweet (3), cheese (2), French beans, coffee.
Aversion: sprouts, cauliflower, fat, bacon, butter, broad beans.
Menses: profuse, sometimes every 3 weeks.
Sleep: bad << hot flushes.
AnalysisThe joint pains improved on Caulophyllum, which also helped her to accept the fact that her daughter had to leave home. But the hot flushes did not go away. After
Sulphur and
Carboneum sulphuratum she got the arrhythmia attacks. It was obvious that the case needed to be looked at again thoroughly.
The complaints started after the death of her mother and mother in law. This may indicate the Muriaticums or
Phosphorus. The hot flushes do not fit the
Phosphorus picture, but they do fit the Muriaticums in general. But there again, the palpitations are not really characteristic of a Muriaticum. The generals fit neither of these two remedies.
So what is really characteristic in this case? First of all there is the anxiety about her disease, secondly she likes to push on till she gets her own way, and thirdly she has very strong ties with her family. Common to these three points is the theme of self confidence, which appears to be quite strong, but which, on a closer look, turns out to be rather doubtful. She needs her family to keep herself going. This leads us to the
Carbon series and to stage 11, which is Nitrogen. Then it suddenly all fits together: the palpitations, the hot flushes, -> sweet, cheese (2), French beans, < fat, bacon, butter, broad beans, warm blooded, obese.
ReactionOne month after Nitrogen 1M she feels better, calmer, and far less hurried. She takes things as they come, saying ‘Everything will turn out all right in the end’. She feels very good inside herself. The hot flushes disappeared very soon after a short aggravation.