Black Lead-The Male Fertiliser
NATIONAL JOURNAL OF HOMOEOPATHY 2003 Mar / Apr VOL V NO 2.
Dr Sagira Chimthanawala
'Graph

An obese Salesman aged 36 years, referred by an Endocrinologist for oligospermia, reported at Shaad on 10/6/02. A known case of Diabetes Mellitus (NIDDM) with blood sugar levels well controlled by anti-diabetics, but felt exhausted on least exertion. He also complained of poor erections and premature ejaculations. Married since 7 years. No conceptions. He also suffered from acidity, constipation and bleeding piles off and on.  Sexual urge was normal, but unsatisfactory copulation made him depressed and guilty. Had used market preparations (Viagra, Fertyl M, Nuvir, etc), but with short-lasting effects. Diagnosis of oligospermia fueled his depression. He had taken some Ayurvedic & homoeopathic patents and drugs like Selenium, Caladium, Yohimbinum and Damiana mother tinctures with no effects.
Had suffered from recurrent UTI and eczema till 20 yrs of age. Managed by symptomatic remedies. H/o Masturbation and Tinea Cruris.

Mind: Temperamentally he was depressed, sad with little inclination to work. Constantly worried about his future, wife and family. Apprehensive and timid. Hated music in every form. Decision making-poor.
Appetite - Erratic.  Disturbed sleep from dreams of daily business. Startles in sleep.
Takes Alcohol 1-2 times / week. No smoking or other addictions.
Both parents had Diabetes mellitus. Elder brother was hypertensive. Wife was examined and was normal.
O/E-Obese, (85 Kg) Fair, bulky with dry skin & cracked soles.
Pulse- 80/min, reg. BP-140/90 mm Hg.
Systemic examination-NAD O/I-ESR-8 mm.
Urine Sugar +. Albumin -ve.
Blood Sugar F-118 & PP-182 mg/ dl.
S. Cholesterol-244 mg/dl, HDL-39 mg /dl, S.
Triglycerides-160 mg/dl.
VDRL-Non Reactive.
Semen Analysis
Vol-4 ml,  pH-Alkaline,  Appearance-hazy.
Liquefaction-within 1/2 hr.
Count-Sperm count-20 mill per ml.
Motility- 60%,  progressive forward.
Morphology-50%  Abnormal  Forms.
ECG-WNL.

MANAGEMENT
Acid -phos Q BD was started empirically and he was advised to reduce the dosage of antidiabetics. After a fortnight, one dose of Graphites 1M was given on the basis of the presenting totality. Acid -phos omitted. The patient was given regular sittings of counseling and reassurances every week.

Expectedly, within 2 months, the mental state improved but the anxiety persisted. Started undertaking tours and could achieve a target within time (first time after 4 yrs). Even after three repetitions of the indicated remedy in increasing doses and interpolating with Sulphur, the semen analysis always presented a gloomy picture.
The case was posted for discussion at our regular clinical meeting. Drugs like Nuphar-luteum, Bufo, Staphysagria, Capsicum and few others were debated. But finally the mental and physical generalities along with the contradictory nature of sexual symptoms (increased desire with impotency) confirmed the selection of Graphites as the indicated remedy. Few seniors on the basis of their past experiences suggested that a rare drug like Tribulus-terrestus has shown unbelievable results in such cases, hence should be tried for increasing the sperm count.

So, Tribulus-terrestus 10 drops in ½ a cup of water TDS was advised for 1 month. Strict diet restrictions, mental relaxation exercises, appropriate weight reduction measures, regularization of daily routines were asked to be adhered to. Within a period of 3 months, his mental as well as physical state improved satisfactorily.
Surprisingly, this ancient Indian remedial agent (Ikshugandha) brought smiles much beyond expectations. His wife conceived after 6 months of the drug. She delivered a healthy male baby by LSCS (Elective). It had to be undertaken because she was an elderly primigravida with lax uterine contractions. 

He is still under follow-up and is on Placebo. On 1/5/03, he weighed 79 Kg and his blood sugar levels are well under control. (FBS- 106 & PPBS - 182mg/dl, S. Cholesterol - 210 mg/ dl: 11/5/03).

INFERENCE
From this case we may enlist certain valuable clinical tips namely:

1. In cases where the maintaining causes persist, then even the best selected remedy in appropriate potency and dose does not show expected results.
2. Ancillary measures like diet restrictions, regularization of routines, psychotherapy, avoidance of maintaining factors, etc, are essential to achieve adequate results.
3. Partially proved remedies help to overcome difficult situations either by acting as palliatives, complimentaries or intercurrents.
4. In the above case, Tribulus-terrestus has complimented the action of the indicated remedy.
5. Apart from the constitutional therapy, it seems probable that the cessation of anxiety of not having an issue (impotency + infertility - maintaining cause) has played a major role in controlling the sugar levels - a psychosomatic tubercular constitutional state. Of course a dose of Graphites 1M had to be repeated last month for his skin problems which are under control.