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Case Study

Visa to Good Sleep
NATIONAL JOURNAL OF HOMOEOPATHY 2004 May / Jun VOL VI NO 3.
Dr Rama Hariharan
'Samb / Sulp

One of the least glamorous systems of the human body is also a big advertiser for the efficacy of the Hahnemannian doctrine of Similars.....yes I am referring to ENT, that bane of mainstream medicine that usually advocates surgery whereas even a neophyte in Homoeopathy will show miraculous cures by diligently following the Master.

A good night’s sleep is as important for the student or the harried housewife, as it is for the high profile businessman. Snoring, blocked nose, sneezing, constant mucus in the throat are some of the mundane problems that affect the quality of that all-important daily journey to snooze land. I wish to share with you a few efforts to remove some of the roadblocks homeopathically-swiftly and gently.

Mr S, a stocky, 55 yr old entrepreneur came with a nose-block since 4 mths, that affected his sleep. Missed sleep meant a bad day at the factory, which for this small-scale industrialist, was disastrous. This ambitious engineer had set up the factory against all odds and he was not going to throw it all away to a nose block and sleeplessness. He tried various means of solving the problem, but to no avail.

The nose block was present all the time < during sleep especially if under the fan. Also ears blocked with a constant buzzing sound, sometimes his own voice reverberated. The painless block would come and go by itself. There was no mucus present anywhere.

Sleep was disturbed by "snoring" .....his attempt to clear the nose block and he could not sleep again. He was scared of going insane due to lack of sleep. By evening, the tension would build up and the fear would set in...."Will I get sleep tonight?" So tranquilizers became a habit.

On the Physical Frontier: Urge to go to stool immediately after eating with no discomfort; urination frequent at night especially with inadequate sleep; loves pickle, but very careful with diet since IHD 10 yrs ago; no alcohol/tobacco; thirst normal; bath according to weather. Sweat, non-odorous/staining was excessive all over especially scalp, provoked by the least exertion, irrespective of the weather. He repeatedly said that he felt good after sweating so would use the A/C very sparingly. He always liked the breeze, but his nose would close up with the draft at night! Medium cool climate was his preference and he loved the rains. He walks daily

Past History: Smallpox as a child, tumour in liver surgically removed during childhood, mumps in 1971, HT since 1984, periodic dry cough/colds for past 4 yrs.

Family History: M- Ca skin of face, surgically treated and survived for 30 yrs subsequently. She had NIDM at the end of her life.
Si: died at age 34 of chronic Schizophrenia.
P/E NAD. Echo-cardiogram of last week-thickening of septum and hypertrophic cardiomyopathy with mid-ventricular obstruction out of proportion to systemic hypertension.
Blood chemistry:
 Mildly elevated LDL
As a person: 
Very positive in life. Since childhood dreamt of having a factory. After working for several years in a MNC, started from scratch and is now reputed in his field. Now, with one attack, he feels he is unfit for business. ."Today honesty has no value." Likes company, but will not go out of his way to cultivate friends. Used to be very jolly, but has become very serious now. Was short tempered earlier. He does not get irritated for trifles, but on larger issues: Can express his opinion easily. Can be a patient listener and has a loyal band of workmen. Principles in life are important for him.

He is close to his siblings, has a happy family life and is always ready to help the needy. He does a lot of charity quietly. Prays daily and believes innately that the power of the divine will never let anybody down. He attributes his success, after an initial turbulent period, to his favourite God. His favourite mythological characters are Karna for his largesse and surprisingly Ravana. He admires Ravana’s "Bhakti", his ability to concentrate, meditate and get all his vast powers through his prayers.
Fear of a totally closed dark room, surgery, not getting sleep at night and so going insane. His sister’s illness started with sleeplessness and he vividly recalls her last stages of struggling with her mental illness.

Analysis
This stockily built man had good eye contact, expressed himself easily, sat comfortably and exuded a quiet sense of power. The disproportionate fear of sleeplessness resulting in insanity, profuse sweat that did not bother his determination and boldness to venture on his own despite a well paid job and that too in middle age, were the key to his case. As the nose block was the presenting symptom, the big 3 of nose obstruction at night somehow did not seem to fit. He had too much energy for Am-carb, too bold for Lyco and no lifestyle abuse for Nux-v. A small remedy that covered the nose block and the profuse sweat not bothering him was Sambucus. I was also thinking of Opium "fear of fright remains" and Merc-sol that also seemed to cover the rest of the case. A quick reference to the Materia Medica made my choice clear as the discomfort for which the patient came was of primary importance.

7/5/02 Sambucus 200 7p OD
20/5/02 Nose block >, ear block > Sweat > even on scalp, fear, urination frequency same-Sambucus 200 7p OD
15/6/02 Noseblock > not constant now. Sweat >. Fear less yet still on sleeping tabs-Sambucus 200 15p OD
24/6/02 Sweat on scalp minimal. Now sweat on face ++ so daily cold with blocked nose. Fear still same. So now I decided to do something about the fear-Opium IM 1p SL 14p OD Sambucus 200 in bottle as SOS.
12/7/02 Fear > . Has halved the sleeping tab dosage and is confident of giving it up. No cold. Noseblock still present. Sweat all over not so profuse. Opium IM-1p SL 20p OD
12/8/02 Was fine till the medicines were on. No noseblock!! Able to sleep better and took sleeping tabs on alternate days. Gradually since last week, all symptoms returned-no sleep at all last night, fear of insanity again, nose block returned: Opium IM 1p od Sambucus 30 6p bd SL 6p OD Sambucus 200 3p OD
29/8/02 Cardiologist happy with progress. Now only on antihypertensive OD. Nose block improved considerably, frequency less and also lasts for shorter periods. Some nights nose completely open!! Sweat >. Since 3 days old symptom of ear block and noises disturbing sleep < left, night, lying on either side. His old fear was slowly returning.

Though, according to Herring’s Law, he was probably getting better overall yet if I did not intervene then his overpowering fear would spoil the progress. It was a tough call. Schroyen’s Repertory was consulted pg1438 Sleeplessness, frightened easily Chin, Rhus-t. The rest of the rubrics for the local problem did not seem to indicate any related remedy. Chin 200 6p OD. At this stage, I selected Chin as I felt that the action of Sambucus was over. He still kept harping about ear-block and noises. Chin covered this and also sleeplessness and fright.

16/9/02 He telephoned to say last medicine very good. Nose block 95% >, only returns if sleep directly under the fan. But ear block and noises still present. Sweat >. Chin 200 4p weekly twice .

5/11/02 Nose block >. No discomfort due to it. Ear block and noises > Sweat >. Now sleepless due to excessively gassy abdomen. Abdomen feels full, appetite lessened especially dinner gas accumulates < night. No extra tension at home/factory Schroyen’s Rep pg 726 abdomen flatulence, preventing sleep has only Kali-mur. Chin 200 6p BD Kali-mur 6x BD

3/12/02 Report: Last medicine no difference. Though sweat OK, nose block gone, but ear block/noises back. Abdomen still distended often and sleep erratic so back to the sleeping tabs. Overall fear >. On closer questioning the hurried, fast eating seemed to result in the gassy abdomen.

I looked again at the case: draft <, cool >, night <, rectum urge, eating after; sweat, profuse; sleeplessness, fear of it; desire spice. Bold, natural leader. Stocky; natural discharges > the totality was unmistakably Sulph . Murphy Rep pg 487 Ear stopped sensation, pg 422 ear noises had Chin, Merc-s, Sil, Sulph prominently.

Rx Sulph IM SL 20p OD
6/01/03 Report No Fears, No Ear Noises, nose block occ but not bothering him, Sleeping Well.
So this demonstrates how even a small remedy does wonders. But the cure is lasting only when finally followed up by the constitional anti-psoric.