Cyclamen-europaeum: Terrors of Conscience
NATIONAL JOURNAL OF HOMOEOPATHY 2002 Mar / Apr VOL 4 NO 2.
Compiled by
T K Kasiviswanathan
'Cycl

There are five main elements to the essence of Cyclamen, as emphasized by Robin Logan.

1. Delusion, neglected his duty that he has.
2. Grief, undemonstrative.
3. Reproaches himself.
4. Forsaken feeling.
5. Conscientious about trifles.

The first rubric is central to the personality of this remedy. The following repertorial rubrics, which reflect that feeling, as stressed by Logan, enable us to understand the essence.
Criminal, that he is a;
Crime, as if he had committed;
Persecuted, that he is;
Wrong, fancies he has done;
Neglected his duty, he has;
These feelings, along with self-reproach, come out very strongly in all the cases that we will discuss in this study and more particularly, in cases of Dr Rajan Sankaran and Dr Falguni Kharewala. Other features are also seen in some cases; in two cases, the patients were fastidious and very good at work and hence ‘conscientious about trifles’.
The grief of these patients is of the type which is completely suppressed and unexpressed; grief which is expressed only when alone or grieves such that others are not aware of it; puts up a brave face in company, like Ignatia. Cyclamen can be called a female Aurum; but unlike Aurum, Cyclamen will not contemplate suicideeven in their  deepest depression or despair, and one can see that it does not appear in the rubrics "Suicidal", "desires death" or "presentiment of death".
Patient’s observations and expressions in clinical practice which guide to this remedy are:
"I hate letting people down; it can worry me for days" (Conscientious);
"I wish I could be less preoccupied with myself" (Reproaches himself);
"I have always been reserved emotionally" (Grief undemonstrative);
"I am too hard on myself; a friend let me down recently and I found myself blaming myself; I felt that I must have done something to cause it" (Reproaches himself);
"I have a friend who is suffering from depression and I feel it is my duty to visit her everyday and give her my support. It is draining me, but I could not cope with the guilt if I did not go every day" (Delusion, neglected his duty, he has);
"You can’t write off people just like that" (Delusion, neglected his duty, he has);
"I have never done much entertaining because I like to do things perfectly and our conditions have never allowed that" (Conscientious, about trifles);
"I have always found it difficult to do nothing. There is always the thought at the back of my mind of what I should be doing."
Logan Robin, Homoeopathic Links 2/93

Cyclamen is predominantly a woman’s remedy and closely allied to Puls. It is often called "chilly Puls". This remedy can be said to be a cross between Puls and Natrum-mur. They are less soft and less dependent than Puls and have more self-sufficiency and independence (Logan).
The distinguishing points are:
Temperature: Cyclamen has a strong aggravation from fresh air or a difference in temperature. Though some Puls patients can be quite chilly and aggravated from cold, but they always want fresh air.
Thirst: Cyclamen tends to be thirsty opposite Puls.
Visual disturbances: are very characteristic ie flickering in front of eyes; shooting of light; foggy vision; double vision etc. These accompany many of the complaints.
Great tendency for menses to be suppressed, tending towards amenorrhoea. Dysmenorrhoea is quite severe and sometimes described as if they are ‘almost going into labour’. Menses are often clotted and dark; too early and too profuse. (Puls-delayed and scanty menses). Tendency to anaemia.
Cyclamen can be effective in migraine headaches. Arthritis may be prominent in feet, ankles and heels.
Let us now discuss some cases of this remedy from our rich heritage.

Case 1:
A 35-year-old lady consulted Dr Prabha Patwardhan for recurrent coughs with congestion and fever and occasional attacks of wheezing since the past 2 years. The complaints were worse in summer. She also complained of acidity, fullness and burning sensation in right epigastrium < eating even small quantities of food, since past 2 years, < spices and < tensions. She had depression and mood swings < before menses. Menses were regular but heavy, clotted and painful. Has leucorrhoea 10 days before menses. Disturbed sleep. Allergic asthma. Had suffered from typhoid and had tonsil operation and appendicectomy.

Life Situation:
The patient had a disturbed childhood; parents had a lot of marital problems. Her father, an alcoholic, used to beat his wife and children. One of her brothers became a drug addict and did not have a steady job. She could not see her mother being beaten up and hence would hide behind a newspaper. She was afraid that her mother would go away from home. Once her mother took sleeping pills to end it all. She had an extra marital affair when patient was 12 y. Once she left to go to her own mother’s place and returned only because of the patient. The patient felt guilty that her mother was suffering because of her. She wept while narrating all this.
She was dark in complexion and was sensitive when someone spoke badly about her looks. After marriage she developed good relations with her mother-in-law, but when the latter fell ill, the mother in law complained that the patient did not care enough for her, in spite of the fact that the patient took very good care of her. This added to the patient’s guilt for no fault of hers. If her children did not do well in school, she felt responsible. She also blamed herself for her poor sexual life. She had a feeling that both her husband and mother-in-law were doing more housework than her.
She had dreams of death and palpitations after a close cousin’s death; dreamt about mother being ill and being unable to cope with it; dreamt about her father’s illness and woke up feeling that she could not do enough for him. Dreams of falling.

Case Analysis:
The essence of the case is the feeling of guilt that the patient has harboured from her childhood, blaming herself for everything, right from her mother putting up with her father’s beatings, the illness of mother-in-law, to her children’s poor performance in school etc. She feels that she has committed a crime. Dreams also show that she feels that she had neglected her duty towards her family. She also fear or sense of being forsaken when she felt that her mother would leave her father, or when her mother went away to her parents’ place.
The Rubrics Are:
(SRI 327) Delusion, neglected his duty, he has
(SRI69) Anxiety, conscience, as if guilty of a crime
(SRI 260) Delusion, crime committed a, he had
(SRI 260) Del, criminal he is a; Delusion, wrong has done
(SRI 832) Reproaches himself
Cyclamen comes out prominently, when one takes into account the menses troubles also. The patient was given 3 doses of Cyclamen 30 and after 2 weeks the patient reported that her asthma was better and sleep had also improved. Acidity was less.
3 more doses of the remedy in 200 potency to be taken as SOS, if complaints recurred. They did not recur and the patient was monitored regularly for a few years and she was doing well. -IJHM 2/94

Phatak summarises the essence of this remedy as "ill effects from inward grief and terrors of conscience". Here is a case, which exactly represents the above essence and proved curative!

Case 2:
A 50-year-old Catholic lady, headmistress of a primary school, came for psoriasis in Dec 1990, of 4 years standing, starting in the neck and spreading to her scalp and to nape of neck. The itching aggravated with sweating and when she was tense. She also complained of sciatica of the right side, which was worse every summer. Medical history showed that she was operated unsuccessfully for bilateral blocked fallopian tubes and later had to undergo hysterectomy for fibroid in 1987. She had severe menorrhagia, which started around the time she had psoriasis. She wakes up from sleep at 2-2.30 AM, mulling over the events of the day, and falls asleep when it is time to get up.

Life Situation:
Her parents were strict, but she was like a tomboy, mischievous, fond of running around and fighting with friends for which she was punished and sometimes also for no fault of hers. She used to feel that she was not wanted. 7 years after her birth, her mother gave birth to her sister and she naturally had to attend to that baby, which was not appreciated by the patient. Then her mother had to leave her with her father and aunt as she had to go with the younger child to attend to her sick mother-in-law (Forsaken feeling). Her aunt who had no children of her own, did not show any affection to the patient. The patient became rude, defiant and irritable and lagged behind in her studies, which forced her mother to come back to handle her. After graduation she became a teacher and after 21 years of service became the headmistress of the primary school. She was conscientious and a perfectionist, and at the same time, helpful to others. The job gave her a lot of tension and she felt frustrated as she felt hampered in taking decisions. Psoriasis developed after an incident in her school, when she refused admission to some kids without the customary interviews and their parents came in a morcha and the school management forced her to interview the applicants. She went into depression for which she was advised to take leave.
She felt guilty when she had to give admissions under duress, when she could have given the seats to more deserving pupils. Once, a boy, while getting down from the school bus was involved in an accident but she blamed herself for that accident. Secondly, her husband had haemoptysis while her school was having an inspection and he died before proper medical treatment could be given. She did not weep openly but wept bitterly inside. She felt that she could have done more for her husband and felt as if she had committed a crime, and that because of her pre-occupation with her school inspection she had neglected her husband.
She was initially prescribed Staphysagria and Aurum on these symptoms with only partial relief.
The main essence of the case was her sense of duty and her feelings that on some important occasions she had neglected her duty and anxiety of conscience of having committed a crime.

The Rubrics Are:
Delusion, that he is a criminal; as if he had committed a crime; that he is persecuted; that he has neglected his duty. Conscientious about trifles; Anxiety of conscience as if guilty of a crime; Remorse and reproaches himself. Grief undemonstrative
In the backdrop are her child hood impressions viz
(SRI 263)Delusion, deserted, forsaken is
(SRI546) Forsaken feeling
(SRI 570) Grief, undemonstrative (on her husband’s death and the boy’s accident)
In these rubrics also Cyclamen appears; in first two it is in second grade.
She was given Cyclamen 200 one dose on 22-12-92. She started improving and was doing better for nearly 3 months with less itching and reduction of psoriasis on her neck and ears; When her psoriasis became worse and her sleep was disturbed, 10 doses of the remedy were repeated in March 1993 and later the potency raised to 1M in April. She improved a lot and when her itching was severe and her sciatica returned she was given another dose of Cyclamen 1M in May 93 and she remained well thereafter. She was able to handle her tension better and place herself in the shoes of the parents seeking admissions to understand their anxiety and concern.
-Dr Kirtida Shingla, IJHM Vol 28 no 2

Case 3:
A 25-year-old woman consulted Dr Deborah Collins for stiffness and pain in her neck from which she was suffering for the past 15 years. Her right arm had become weak and she got cramps while using that arm and hence could not write more than 4 lines about her complaint. The pain and stiffness were better by warmth and massage. There was weakness in her feet and also some trembling; sensation of paralysis in both the limbs with cramping pain. She also reported to having a tendency to faint and seeing stars before her eyes. Coupled with these complaints, she got back pain, which made it impossible to walk. She felt as if she was worthless.
Her life situation revealed that she suspected that her parents were not her real parents and wanted to see the marriage certificate to confirm that, even when she was only 7years old. She revealed a tremendous guilt feeling when talking about her complaints. She said that her parents were always quarrelling and she felt tossed between the two, for which she blamed herself. She blamed herself even for others’ mistakes. She also experienced weakness after taking contraceptive pills; had weakness and irritability and diarrhoea alternating with constipation for some time after the first child. Other symptoms were intolerance of sun, desire for open air, desire for smoked meat and aversion to sweets, fats and beer. Thirstless during day time but thirsty in the evening. All her complaints were worse on the right side and sleep was unrefreshing. Worse in cold wet weather and storms. She wept while telling her symptoms and weeps easily. There was a history of TB on the maternal side. She had hormonal problems and continuous milk secretion for 3 years after the first child.
The remedies considered were Puls, Tub and Cyclamen. The first two medicines repeated after every two months did not give relief. She then developed some more symptoms: vertigo with dim sight, spots and flickering before her eyes. In the meantime she got pregnant again; she became terribly weak as had happened in the first pregnancy. There was a history of premature labour pains in her family (such labour pains before menses is another symptom of this remedy) and the patient feared that because of that the child might be born prematurely and would have congenital defects. She also felt guilty that she was not able to look after her other two children and said that she was no good at all.
She was prescribed Cyclamen on the basis of the rubrics: Delusion alone in the world; anxiety of conscience; aversion to going out; undemonstrative grief; offended easily; reproaches herself; pain upper limbs, right side; pain, cramping, right knee; and chest milk in non-pregnant woman. One dose of the remedy in 30^thpotency was given. With that dose, all her complaints disappeared after 2 days. Three months after that dose she developed premature labour pains at about 30^thweek which was tackled by Viburnum-opulus and Aletris-farinosa. The delivery was normal and her constitutional remedy was Cyclamen which was repeated in 1M three times whenever there was relapse of her complaints. The follow-up over a five year period showed that she had been in good health since then.
-Deborah a Collins, Homoeopathic Links 1/96

Case 4:
The same doctor reported briefly another case of this remedy. The patient was also a woman who was doing well under Puls 1M but was only 70% better and was not fully cured. Her complaints (not given) relapsed and increased in intensity and during the follow-up stated that she felt guilty that she did not stop her mother from complaining against her father who was ill at that time and was dying. She felt morally wrong. She did not have those kinds of emotions before. She flushed and wept while narrating the symptoms. She wanted to be alone and lying in bed all day (a characteristic of this remedy). Talks loudly, even when alone. She had aversion to fats and desire for open air. Her complaints were relieved only after administration of Cyclamen 1M. In this case the desire for open air, which is characteristic of Puls was present but did not contra-indicate the remedy as the main essence in this case is her mental concomitant of guilty feeling as if she had committed a crime. - Deborah A Collins

Case 5:
Dr Deborah A Collins also refers in her article to the similar situations of two other women who were cured with this remedy. Both were very concerned with their health and any mention of disease was enough to frighten them; one had a fear of heart attack while the other of apoplexy. During such panic attacks they would be dizzy and their vision was blurred or they would see flashes or coloured spots. On walking unsupported, they found everything outside seemed to wobble, but a gentle touch on the shoulders removed that complaint. This often ended in headache. Both had good marriages and their husbands were the understanding types. One woman was very fastidious and strived to do everything perfectly. She, being a schoolteacher with a class of 30 pupils, would say it was her fault if one child lagged behind in study. It took a long time for her to decide to have a child of her own, as she was afraid that she might in someway cause damage to the unborn child. She felt responsible to hold the family together. For her, death meant losing touch contact with her husband and family. She was given Cyclamen in LM doses and her headaches and visual problems vanished and she became much less fastidious and less critical of herself for the failure of her students.
The other woman patient expressed her sense of duty like this: "I can never allow myself to take it easy in the house; I must clean the house everyday and make sure there are fresh fruits and vegetables. I would never forget a birthday. I am very accurate about getting photographs in their proper place and sequence in their album. My children’s clothes are always neat and in good repair." (Conscientious about trifles) This patient also felt guilty when her son had a tiff with his girlfriend. Cyclamen also helped her a great deal.
It is significant to note in this connection, the botanical properties of this plant.
"Cyclamen plants grow sheltered in the root system of large trees. Unlike most plants, which tend to scatter their seeds far, Cyclamen holds on to its seeds for almost a year, until they are ready to germinate, and then spirals them down and plants them in the ground, firmly beside herself." - Dr Misha Norland

Case 6:
A 34-year-old woman consulted Harry van der Zee. She was in her 24^th week of pregnancy. She was tense, restless and sleepless, and she had had the same symptoms during her first pregnancy. The parturition was a traumatic experience, as she was apprehensive and tensed up and confused with doctors and nurses attending on her. She was afraid that she would do something that would cause damage to her child; after her labour she felt that she had failed as a mother. She could not feel happy with her child and felt guilty about it. She did not get over her delivery pangs and hence did not want any visitors and desired to be left alone. But at the same time if there were no visitors she wondered whether she had done something wrong. Her memory and concentration were bad and once she could not remember her child’s name. Her menstrual history was that she was sleepless before menses; had epistaxis during menses, and headaches during ovulation. Constipation before menses but better during menses.
Cyclamen 1M was prescribed on the characteristic mental make-up of the patient (feels guilty and reproaches herself etc, coupled with her menstrual troubles, desire to be alone and feeling of being forsaken when there were no visitors) and she was better. It was repeated when needed and her menses became regular and her headaches decreased. One year later she conceived again and was found to be more relaxed and sleeping better.
-Harry van der Zee, Homoeopathic Links1/96

Cyclamen like Puls is predominantly a female remedy (though Hahnemann proved it on males only) with its characteristic chlorotic and menstrual complaints. Here is a beautiful case of Dr Falguni Khariwala, where the remedy cured a male patient who exhibited the same mental symptoms.

Case 7:
Mr B, aged 35, came for the treatment of severe attacks of bronchial asthma, with cough, chest pain, backache and fever aggravated by coughing. There was severe wheezing and the patient was very sickly.
The patient was found to be mild and reserved and seemed to be under intense grief. The doctor noted the peculiar movement of his eyes moving rapidly between the doctor and his assistant, and it was accentuated whenever the doctor probed into his mind symptoms; the patient also had tears in his eyes when this was being probed. Despite much persuasion, he would not disclose the reasons for his grief and hence his wife was asked to come for an interview. The wife said that she and her mother-in-law were frequently quarrelling and when there was a quarrel, the patient would be very much affected. He would not utter a word and would go to his room, close the windows and lie down. The next day he would get his asthmatic attacks. She had to apologize and pacify him. He was very duty conscious and would work very hard and would not take leave.
On the next visit, when asked how his wife and mother got along with each other, he did not reply, but his eyes were full of tears and his eye movements were rapid. He ultimately said that when they quarreled he was helpless and could not side with one or the other, even though he knew that his mother was mostly in the wrong. He said that in such cases he would go to his room and lie down. His wife added that even during his asthmatic attacks or during quarrels he would close the doors and windows. He would insist on closing the windows and doors even when he returned from his office. He was not inclined to go out but preferred to stay indoors.
Physicals: weakness in his knees since 3-4 years; appetite is decreased; thirstlessness and offensive sweat without staining; a chilly patient.
The rubrics taken for repertorisation:
1. Grief, undemonstrative.
2. Delusion, criminal he is Delusion, crime committed he has (rapid eye movement and insistence to close the windows)
3. Anxiety of conscience as if guilty of a crime (unable to reconcile mother and wife)
4. Going out aversion to
5. Occupation amel
6. Mild
7. Brooding
8. Reserved
Taking also the physical generals (great lassitude esp. in the evening and with painful weariness and stiffness in the legs), Cyclamen emerges as the similimum. 1M one dose. Next day-no fever, no chest pain and no backache; cough and breathlessness better. Appetite restored. The medicine was repeated two days later in the same potency and within 10 days of treatment, the patient was much better and had no breathlessness, cough and no asthma attack, remained well even after 4 months (no further follow up given). There was slight pain in his knees. -Dr Falguni Khariwala reported in
The Progressive Homoeopath, Sept-Nov1990

Case 8:
A 45-year-old woman consulted Dr Rajan Sankaran for severe eczema on both her legs, which were oozing and painful for the past 2-3 months. She was so disabled that she could not go anywhere. She said that her skin problem could be psychological and that she was suffering from tension. On a query she said that it had nothing to do with her husband, but was related to her family. As she was not forthcoming, the doctor asked about her dreams. She was getting recurring dreams of stools, passing stools or stools lying around. Finally she said: " I have a son who is mentally retarded and he also gets convulsions. Every time he gets convulsions, that night I dream of stools. During pregnancy I had a dream that there were lots of stools and the head of the child was coming out of it, and somebody, God knows who, was pushing it back. At that time I knew that the child would not be okay". Doctor noticed that when the patient was narrating this dream, her eyes were moving fast. (See case No 7 had same eye-movement). She added: "I feel I could have avoided it. I could have done something."
It was clear that she was feeling guilty for having given birth to a handicapped child and hence was hiding this fact from her office staff and avoided social contacts and did not go on holiday trips allowed under her job, as a perk. She looked after her child, as she thought that she alone was responsible, though her husband was helpful. She was very efficient in office.
Dr Rajan Sankaran prescribed Cyclamen, which cured her.

This is another beautiful case where the essence of the remedy is clearly brought out. The patient was bottling up her grief in having a handicapped child for very long (Grief, undemonstrative); her conscience was bothering her as if she had committed a crime (terrors of conscience, which were very marked in this case); The other rubrics such as Delusion, she is a criminal (rapid movement of her eyes and inability to make eye contact with the doctor); Delusion, she has done wrong; Indisposed to talk; Delusion that she has neglected her duty and reproaches herself (I could have done something during pregnancy) reflect the same feeling. Going out of home: aversion to, and company: aversion to are the rubrics reflecting her own method of atonement.
-Dr Rajan Sankaran, Spirit of Homoeopathy

Case 9:
A 65 year old woman consulted Dr Logan for depression, panic attacks, indigestion, a sore mouth and a permanent bad taste; a mapped tongue with a fissure. She was too nervous to travel out of her hometown on her own. She felt exhausted and despondent and woke up every day feeling drained and unenthusiastic. She had dark rings under her eyes and had been taking Valium for years.
She was depressed and grief stricken because she lost her husband, her sister, and a close aunt during the course of last five years; besides, her daughter was having trouble with her marriage. She felt very alone in her grief and found it impossible to share her grief with anyone even if she had an opportunity. (Grief: undemonstrative and feeling forsaken) She was upset about allowing herself to fall sick like that, as she put it. (Reproaches herself) She described herself in work as "far too conscientious for her own good" and elaborated by saying that "she hated letting people down". (Conscientious about trifles). She also said that her moods alternated a lot (moods alternating); she was constantly analyzing herself and her actions. (Introspection). Initially, the doctor gave Natrum-mur in varying potencies but it did not relieve. The patient also had other remedies such as Aurum, Ignatia, Puls, Lyco and Muriatic- acid which seemed indicated but did not help the patient at all.
When the indicated remedy Cyclamen was given there was noticeable change. She was less depressed and had more energy and no panic attacks. She got up feeling refreshed and did not think about how she is feeling, the way in which she used to do earlier. Her sore mouth was also much better
-Robin Logan, Homoeopathic Links 2/93

Case 10:
A lady consulted Dr Rajan Sankaran for sciatica and the severe pain she was having. She was a college professor and a very sincere worker. She alleged that her senior was harassing her in many ways. Her good manners, sincerity to work, and suppressed anger indicated Staphysagria but it did not work. At the next consultation she said "This pain is troubling me so much, it is not allowing me to do my duty". As she felt that her illness was preventing her from discharging her duties, the doctor took the following rubrics:
"Delusion, that she is persecuted"; "Delusion, that she has neglected her duty"; "Anxiety of conscience, as if guilty of a crime". He prescribed Cyclamen which cured her of pain immediately
-Rajan Sankaran, Spirit of Homoeopathy

Dr Clarke draws special attention to the usefulness of the remedy in menstrual troubles. Menses more copious, more frequent; too early, with severe abdominal pains; accompanied with labour-like pains; flow excessive, black and clotted; secretion from the swollen mammae, like milk; menses suppressed. Clarke also refers to cases of other Homoeopaths where the menstrual troubles were associated with chlorosis, with vertigo, and headaches, and with diplopia.

Case 11:
A 24-year blonde girl, with pale skin and lips, had menstruated till the age of 22, got wet during a picnic one day, just when her menses were to start. It stopped at once and was delayed for 10 months. Now the periods were late and came every two or four months, always with pains, starting at the sacrum, extending along to both sides of abdomen, and to the pelvis; and menses accompanied by terrible abdominal labour-like pains lasting for several hours. Eyes were slightly edematous, with pressing pain in forehead and vertigo; chilliness of the whole body and disturbed and unrefreshing sleep with terrible dreams; continued loathing for meat; and vomiting in the morning. Puls gave only partial relief, but Cyclamen made a complete cure, as its provings contained all these symptoms. She developed ocular symptoms which were untouched by Puls, but cured with Cyclamen 15x. She also developed a hallucination as if two persons lay in her bed and that the body of the other overlapped hers by half. It ceased when the remedy was discontinued.
-Quoted by Dr Clarke In his Dictionary

Case12:
In the case of a 16 yr. old girl, the menses got delayed and then ceased. She lost her spirits, wanted to be alone and was offended by trifles; no inclination to do her usual work and she could not be persuaded to leave her house for a walk. She would sleep unusually late in the morning. Complained of great lassitude forcing her to rest frequently; palpitation without cause; more interested in seclusion and then she would weep. During the forenoon, there was vertigo and pressing pain in her head. She was prescribed Cyclamen 15x and after a few weeks her headache and vertigo became less and menses returned and was regular thereafter.
-Quoted by Dr Clarke