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One of the challenges of being a homeopathic practitioner is to persist with a case when things are not going well. Very often, a case will go well from the first medicine prescribed, but there are other occasions when, no matter how hard you try, nothing seems to be working, even when the medicines seem to fit the case really well. It can be hard to keep going and to cope both with your own and the patient's disappointment.

Case Study – Migraine

History

An example of the latter situation is Arlene. She came to see me in my general practice with a long history of migraine. She had had them every month for twenty years, usually just before her period. When her periods stopped at the menopause, she hoped to lose her migraines too. Unfortunately, the reverse happened and the migraines became far more severe, often confining her to bed for one to two days every month. She had a full house of migraine symptoms with the flashing lights before the headache started, and nausea and vomiting during the migraine.

I did not know Arlene very well as she had usually seen one of my colleagues in the practice. However, he had suggested that she came to see me as all the conventional treatments had failed. Likewise, hormone replacement therapy had not been a success, having resulted in a further worsening of the symptoms and some worrying, though fortunately temporary, numbness in her face and hands. I knew a little about the family though. They had been dogged by tragedy over the years. Arlene's father, to whom she had been very attached, was killed in a mining accident when she was eight. She was the eldest daughter and had to 'be brave' to help her mother to manage. Arlene's husband died suddenly of a coronary when she was pregnant with her second child. Her elder daughter contracted leukaemia six years later and also died of a severe infection having initially responded well to treatment.

Interestingly though, Arlene did not talk about her misfortunes. She had been given a brief course of antidepressants after her daughter's death but, apart from that, showed no outward signs of her grief. Everyone in the town marvelled at her strength and resilience. Nonetheless, I felt that I must explore her inner feelings, if we were to get anywhere with her homeopathic treatment.

It transpired that Arlene harboured some bitter feelings towards the medical profession regarding her husband's death. He had been to the doctors on several occasions with chest and upper abdominal pain and had been diagnosed as having dyspepsia, the diagnosis of heart trouble having been thought unlikely as he was only 32 years old. Arlene felt that if he had been correctly diagnosed he could have been successfully treated and perhaps could have survived far longer. However, Arlene had never openly challenged her husband's doctors. Rather, she tended to brood about things internally and to bottle up her feelings.

Treatment 1: Natrum Muriaticum

This kind of internalizing response is very typical of the homeopathic medicine, Natrum muriaticum, which is an extremely good medicine for the kind of migraine headaches from which Arlene suffered. One of its keynotes is 'Ailments from grief' and it therefore fitted very well with an individual who had experienced so many losses and who tended to internalize her feelings about them. So I prescribed Natrum muriaticum for Arlene, feeling quite confident of a favourable outcome.

Indeed, she seemed to do satisfactorily at first. The migraines were less severe after the dose, with less nausea, but never went away completely. I tried repeating the dose at the same potency (30c) and then a higher dose (1M) over the ensuing months. Things progressed even more slowly than they usually do in homeopathy because, with the headaches only occurring on a monthly basis, we had to wait for about three months between every dose to judge the effect.

Whatever I did with the Natrum muriaticum, it just did not seem to have the power to sort out Arlene's case completely.

Treatment 2: Carcinosin

In these circumstances, homeopaths are encouraged to try to find a so-called 'nosode' which fits the patient, in the hope that this will 'clear' some of the patient's underlying tendencies to illness, and allow the initial medicine to work better. When searching for a nosode for Arlene, I looked at her family history of illness and at her basic characteristics. There was quite a strong history of TB and cancer in her family, especially on her mother's side. Arlene herself was a fastidious and sensitive individual and tended to sleep on her front. These features led me to try Carcinosin as her nosode.

The Carcinosin itself did not have any effect, and repeating the Natrum muriaticum after the nosode did not help either. I was stumped. Arlene then mentioned to me that she was getting some more problems with her menopause with uncomfortable dry eye and vaginal dryness. She had also had some excruciating joint pains recently, which caught her every time she made a certain type of movement. At last the light dawned. She needed Bryonia.

Treatment 3: Bryonia Alba

Bryonia alba is a homeopathic medicine derived from the white bryony plant. It is said to be 'related' to Natrum muriaticum in that it can work well alongside Natrum muriaticum or in Natrum muriaticum types of patient. It is very good for treating migraine that is worse for movement or indeed any symptom that is worse for movement, such as Arlene's joint pain. One of its keynote symptoms is 'Dryness' and I have used it successfully for dry eyes, dry cough and vaginal dryness.

After a single dose of Bryonia, Arlene missed a month with her migraine. A further dose left her migraine-free for four months and now she takes a dose whenever she needs one (about once a year). Her joint pain cleared up and her dry eyes are much better although she does occasionally have to use some artificial tears.

Which all goes to show that if at first you don't succeed, it's good to keep on trying…