Asthma After Epilepsy.
NATIONAL JOURNAL OF HOMOEOPATHY 1996 Mar / Apr Vol V No 2.
Kulay F M.
Cases.
` Nat-m / Bufo.

Boys often play in the compound of my building, exuding the noisy spiritedness of youth. Among them is Raju, 24, a healthy-looking boy. I took his case on 17/12/1994 when I learnt that he was a severe asthmatic.

He had been suffering from Bronchial asthma since 2 years which was hereditary. ASthma was aggravated form 10 pm to 12 midnight, and 3 am. Ameliorated sitting BENT FORWARD.

Cannot lie down. Rattling in chest without expectoration. Cough (2+), ending in dyspnoea, Nose-block. Wants air.

Occasionally, takes some antacid for burning in throat and upper chest; agg tea, oily food.

Had been an epileptic from 7 to 17 years of age. Initially on Gardinal and later, he was prescribed Mazetol. The convulsions began with sudden deafness, followed by darkness before eyes and fainting, with stiff limbs and wide open fingers. Had monthly attacks first, then more infrequent, and finally they ceased. Often he had involuntary urination during convulsions. Used to go into a deep slumber afterwards for hours and wake up refreshed. No foaming at mouth, clenching of teeth or trembling.

FAMILY HISTORY:.

Mother asthmatic. Her younger brother suffered from asthma for ten years in Bombay. He was then transferred to Coimbatore, and remained well for the next 10 years. Seven years ago, he was again transferred to Bombay, and continues to be an asthmatic here. His uncles son also suffered from asthma.

Mothers elder brother, who was an EPILEPTIC, has been free from the disease since a severe head-injury leading to unconsciousness, seven years ago.

OTHER DETAILS:

3-4 normal stools a day. Normal thirst for cold water - takes hot tea/ coffee. Craves milk, fruits and eggs in that order. Dislikes fish, sweet, in that order - Likes salt+ - WARM patient.

Never weeps. Sober. Serious. Cannot see human suffering; may go out of the way to help. May get violent when angry. Fears dog and animals in general.

Often he travels to Kerala in connection with his business. Sedentary work otherwise.

TREATMENT and FOLLOW-UP:

17/12/94 - Natrum-mur 1M - one dose.
3/1/1995 - A mild asthma attack at 1 am. Took Bufo 200, one dose (as advised) - felt its action in 15 minutes, and slept off in an hour.

According to him, the attack was precipitated by the three bananas that he ate the previous afternoon but he attributed the attack principally to his financial worries.

Remained well till 15/2/1995.

15/2/1995 - Was in Bangalore. Night extremely cold. Had a severe attack at 9.30 pm. Felt no relief for 1 - 1/2 hours after Bufo 200, and repeated it. "AND NEVER KNEW WHEN HE WENT OFF TO SLEEP". Complaints amel the next morning.

23/5/1995 - In Bombay. Woke up at 12.30 pm with dyspnoea without cough. Sat up bent forward for an hour and slept. Did not take Bufo as the attack was very mild. Well since then. No more Bufo till date (10/4/1996).

30/8/1995 - The last prescription: Natrum-mur 10 M, one dose. No attack after 23/5/1995.

DISCUSSION:

Natrum-mur is in two marks under

1. KR 763 - Respiration, asthmatic
2. KR 766 - Respiration, difficult
3. KR 1351 - Convulsions
4. KR 1353 - Convulsions, epileptic
5. KR 1353 - Convulsions, epileptiform.

Natrum-mur, however, was selected on the basis of the constitutional nature of the remedy, not considering the epileptic past or the current asthma. The following were give weightage:-.

1. Cannot weep
2. Sober
3. Co-operative and helpful
4. Disturbed by human suffering
5. Violent anger.
6. Craves milk and extra salt
7. Dislikes fish
8. Warm patient.

Natrum-mur, however, is not listed under fear of animals, or dogs.

Of significance is the fact that his uncle became an asthmatic in Bombay (Air, seashore, agg - KR p 1344), and the fact that another uncles epilepsy was totally gone after a severe head-injury (Natrum-sulph? - application of a similar but stronger force?). The patient thus seems to be a member of the Natrum family.

Thus far about Natrum-mur, which was given in 1M, one dose first, and another dose in 10 M almost after 8 - 1/2 months. There has not been even a mild attack in the last seven months or so, although he has been taking bananas and cold drinks with impunity, which he used to fear, perhaps unreasonably.

As for Bufo, it is known more for its action on the NERVOUS system and the SEXUAL sphere. it is perhaps missed in asthma because there is hardly any mention of its respiratory distress in detail in our materia medicas. Dr Phatak in his MM (pg 118) writes, "Burning like fire in lungs. Suffocative cough. Asthma." Not much is found in Kent, Clarke, Boericke, Allen, Pierce, etc.

Although Bufo is rich in epileptic symptoms which the patient had in his past and family history, my reason for prescribing it during as asthmatic attack was based on, what may be called BUFO ASTHMA EPISODE.

Bufo has THREE marks in KR under:

KR 1351 - Convulsions
KR 1352 - Convulsions, consciousness, without
KR 1353 - Convulsions, epileptic
and TWO marks in
KR 1353 - Convulsions, epileptiform
Significantly, under URINATION, INVOLUNTARY, CONVULSION, DURING (p 659), we find:
3 marks: Bufo, Hyosc.
2 marks: Caust, Plumb, Zinc.
1 mark: artemisia-v, Cocc, Cupr, Nux-v, Strych.
Bufo has ONE mark in RESPIRATION, DIFFICULT, (p 766), and ONE mark again in RESPIRATION, DIFFICULT, WHILE LYING (P 769). In RESPIRATION, difficult, better, SITTING BENT FORWARD, we have -.Ars, bufo, chin-ars, Lach, Spong.

A less known remedy like Bufo given even one mark in these rubrics is significant. An imaginative comparison will reveal that it is very similar to Kali-carb in asthma.Kali-carb and Bufo, both cannot LIE DOWN during an asthma attack. Kali-carb, however, is better by sitting ERECT; it is not even mentioned under, Better by sitting BENT FORWARD. Ars-alb too cannot lie down, and is certainly better by sitting BENT FORWARD. But both Ars and Kali-carb are CHILLY, whereas Bufo is warm during the attack, and parts company with both on that account, and comes in as a good WARM alternative to them. I have found good results with Bufo whenever a WARM asthmatic complained of - bouts of cough ending in dyspnoea, aggravated lying down, better by sitting bent forward. Worse after midnight, between 1-3 am.

In SR Vol II page 12, Bufo is listed under "Agg night", which means "Worse between 9 pm to 5 am.

The presentation does not really end here. A Homoeopathic prescriber is not satisfied merely by good results. He is uncomfortable if a case leaves behind unanswered questions, or at least a question he cannot really answer. I therefore add the following as food for thought for those who may feel perplexed like me and try to answer the questions in the light of their knowledge and experience.

FIRST OF ALL, we understand that disease progression exhibits an order. We strictly believe that a person is sick in his inner-most, but the underlying disease-force chooses safer avenues for its manifestation as far as possible. Only mal treatment (medicinal, emotional, whatever) drives it inwards, and gradually makes the disease-manifestation more and more dangerous to life. It was from this CRUCIAL understanding of orderly behaviour of health and disease that Dr. Hering derived his Law of Direction of Cure, expressed variously as-

1. Curative remedial action must proceed from. ABOVE DOWNWARDS,
2. from WITHIN OUTWARDS, or
3. from Spiritual level (Mind) to Physical level (Body), or
4. from MORE important organs (Systems) to LESS important ones and
5. in keeping with the orderly behaviour of disease, cure must proceed in the REVERSE order of the manifestation of ailments, and so forth.

A maltreated respiratory disorder may well assault the nervous system in its stride. Raju, however, suffered from epilepsy for ten years till his age of 17, remained well for five years thereafter, and then at the age of 22, he went into Asthma. This DIRECTION defies our logic of expectations. He had been treated by allopathy, and our traditional arrogance cannot be allowed to lay any blame at its door, because the DIRECTION in his case is ORDERLY from a more important system to a less important one.

What then happened? Inquisitive human nature remains restless until it finds an answer to the nagging questions it raises. Even GOOD or PLAUSIBLE reasons will do in place of the VALID one, but SOME answer the human must have.

Dr Hahnemann too was once prescribing Quinine (China) in a routine way to malarial cases, until he discovered the SIMILARITY principle and realized WHY the DISSIMILAR cases did not respond to China. A corollary is that those cases which were similar to Quinine malaria, however few, did respond and got well. Thus, one may suppress many cases by a routinely given remedy, but could also unwittingly, help in a right way those cases which are amenable to the remedial action of the remedy.

This must be the welcome fate of any routinely prescribed remedy. Such a remedy will do no harm to the amenable cases, and will not offend Herings Law of Direction. Some such thing seems to have happened in Rajus case under allopathic dispensation.

SECONDLY, the curative, or at least beneficial, remedial action of Natrum-mur is intriguing. It set out forthwith to reduce the suffering remarkably. After it, there followed in all three asthma episodes; first one a mild attack after 17 days, second a severe one after another 43 days and the last a very mild one after another 66 days - no more asthma, nor a travel in the reverse direction (towards epilepsy). Has the case been already cured? Will it need any more remedies to eradicate the disease totally? And how does a Homoeopath prescribe next in the absence of any indication for the same or another remedy?.

And, THIRDLY, what about Bufo? We often need a series of remedies to cure a chronic disease, one remedy acting efficaciously for a short or long time and then making room for another remedy whose picture had been gradually emerging. Some times, the present picture of a patient is vague, may be unreliable for prescribing, not because the case is incurable and needs palliation, but often because allopathic over-drugging has so masked the picture that one misses THE remedy. Even in such cases, we often arrive at the correct remedy, if we rightly determine what remedy the patient needed earlier in life or before the present state of affairs. We are lucky if we find that the patient needed the same remedy all his life to the one that is still indicated undoubtedly. A chubby child, with aversion to milk, delayed mile-stones, especially delayed dentition, gradually moved into susceptibility to colds, and glandular affections (tonsils, cervical glands), retains all the Calc features, its mind, likes and dislikes and everything even when, late in life, he comes for treatment of tuberculosis. In the case being discussed here, Bufo covered all the patterns of acute exacerbations spread over more than 15 years, be they in the form of epileptic fits or asthmatic attacks.

Bufo seems to have been neglected in Lymphangitis, in shy children (retarded?), lacking self-confidence and making up for it through cunningness.

The study of the materia medica can often be enriched by the habit of browsing through the pages of well-known repertories. It is well-known that Colocynth colicis better by  bending double; not so well-known is the Sinapis colic which is worse by bending double, better by sitting ERECT. This helps in employing less-understood remedies, especially when the case does not fit any of the remedies that we have at our finger-tips. Of course, this does not mean, "Prescribe Tylophora for warts!".