I’ve just read your very good article “Desire for light”.
Let me know: Sepia and pulsatilla , how did you prescribe according to Boenninghausen’s method?”
We get lots of questions regarding the use of Boenninghausens methodology. I think at the outset, it is imperative to establish that the methodology is HAHNEMANNS and that the Therapeutic Pocket Book although collated and arranged by Boenninghausen, is merely the vehicle to be VERY precise in selecting the remedy or group of remedies that contain the collected picture of the patients disorder.
After writing the article yesterday, I looked through the patient files and found the notes and prescription chart for this particular client, and extracted the details of the case.
Here was a male aged 28 suffering with eczema on his arms , neck and torso. Started in teens upon entry to university. No family history of skin ailments, but younger sister had developed asthmatic symptoms recently. No history illness of note regarding illness.
Although this patient was referred to another colleague in the clinic, it was our habit to meet together every morning prior to clinic and discuss cases. This case was brought to my attention because of the severity of the eczema outbreak. and the lack of symptoms in an atypical case.
The patient was coming to us from the emergency ward of the local hospital after being prescribed 1M Acontite, 2 doses which flared up his eczema and became extremely uncomfortable with it. He had been treated with corticosteroids atopically and antibiotics. He still wanted homoeopathic treatment despite this experience but decided to change practitioners hence his arrival at our doorstep.
My colleague had taken his case, but as the patient had been relieved of the pain and severity of the eczema under the steroids, had asked him to wait a week, not apply the steroids and then come back. I was requested to sit in on the second visit.
Nothing of note to mention in the presentation of symptoms. In examination of the eczema, I was struck that each patch, though varying in size and colouration, were almost circular in appearance. (discoid)It was a hot day and when he came to the clinic he had been walking in 100F heat for a few minutes and was sweating. He was very itchy and uncomfortable. He kept rubbing his arms and body, which for eczema is a normal thing to do. In questioning him, he stated that he took a shower first thing in the morning and at lunch time and in the evening and dried himself really well, and his skin felt really good for it. He said the skin was very comfortable in his home when he worked after showering, but if he had to go outside in the heat it would get worse.
My colleague noted ” better for bathing, better for being cool,” but was not happy with the remedy choices coming up and felt she could not prescribe properly on that basis.
I sat and thought about the patients statement to us and retraced his words in my mind. I looked at him and realised he was in a cool place, our clinic but was NOT comfortable, he was scratching. I asked him to go to our shower room and take a shower and we would talk again in 20 minutes. My colleague and I went for a coffee and I said to her that this way we could see if his observations would hold true.
When we reconvened, he was MUCH happier in himself and the itching had diminished completely. My colleague was still not happy with her choice of symptom, “better for bathing is a pretty common symptom in skin ailments” she said.
I looked at the notes again and slowly it dawned on me that in each and every occurrence of aggravation, that he had been in the heat, and furthermore had been SWEATING. The sweat was the cause of the aggravation. It irritated his skin. I asked him to go for a walk from our clinic room to the front entrance of the building via the perimeter and come back. It was only a 5 minute walk, but in the sunshine and the heat. When he came back, he was itching again, there was a thin film of perspiration on him. He was requested to wash ONLY one arm and dry it. That arm stopped itching. The other body parts did not.
We prescribed thusly:
The combination of the presentation… circular eruptions combined with the aggravation from perspiration was enough to characterise the nature of his disorder and was peculiar to only SEPIA.
Q potency 0/1 (LM) once daily. We raised to Q potency 0/2 in 3 weeks and the eczema resolved in 7 weeks. After 7 weeks he had a brief respiratory infection which resolved with Pulsatilla.