Small Remedies in Everyday Practice(Fall 1994)
David Wember, MD, DhT

ABSTRACT: Dr. Wember yet again presents us with many clinical pearls regarding the utility of smaller remedies for everyday clinical practice.

KEYWORDS: acne, arthritis, asthma, chronic fatigue syndrome, cough, infantile colic, fibromyalgia, heel pain, knee, rheumatism, sciatica, sinusitis, synovitis.

I would like to talk about remedies I have learned to use in the past several years. Most of these are small remedies which I have found quite useful in acute situations. Often specific rubrics have led me to these remedies. One of the special qualities of homeopathy, for me, is how a strange, rare, and peculiar symptom can make a difference in finding the correct remedy. Obviously, the practitioner must pay attention to the entire picture, yet these small differences allow us to experience the uniqueness in each patient. Let me begin by talking about several remedies I have used for ASTHMA. We all know how disruptive wheezing can be to someone's life. Sometimes it occurs only in a specific situation. A patient recently told me she cured her allergy to dust. She was in a health food store and told them she became asthmatic every time she dusted. The proprietor looked up his computer program and said that POTHOS FOETIDUS was the only remedy listed for that condition. She took the remedy and can now clean house without wheezing. We never stop learning from our patients. They are often our best teachers. Remember the keynotes of POTHOS: asthma relieved by stool; a red, butterfly-type rash across the bridge of the nose, like that in Lupus; and an overlooked symptom, severe tension and bloating in the abdomen, often described as 'hysterical tympanitis.' Another remedy involves an allergic sensitivity to horses. I have had several cases of asthma, related to horses that have been cured by CASTOR EQUI. This remedy comes from the rudimentary thumb-nail of the horse. I can think of one particular teenager who very much loved to ride, yet she was having great difficulty just being around her horse. She needed an inhaler every time she entered the barn. With this remedy, CASTOR EQUI, she was able to continue her riding without the need of drugs. Sometimes the sensitivity is due to the mold in the barn. For this, a remedy made from the specific barn mold can be quite helpful. I often see patients, especially young patients, with exertional asthma. As in other asthmatic conditions, it is always important to identify and eliminate the offending allergens; most often dust, mites, mold, foods, etc.

In the past I talked about ICHTHYOTOXIN, eel serum, which is called the Digitalis of the kidneys. ASPIDOSPERMA, from quebracho, is called, by Hale, the Digitalis of the lungs. One of its main symptoms is exertional dyspnea, like LOBELIA INFLATA. I use it in the tincture. In congestion, the first thing I ask my patients to do is to stop eating dairy products. Hahnemann was not opposed to proper nutrition. The high molecular weight proteins, like casein and whey, are often allergenic and cause congestion. Some extra Vitamin C acts as an antihistamine. I use these as adjuncts to the remedies. If you did nothing else but stop dairy products, it is my opinion that 50% or more of these children would cease their recurrent congestion and even otitis media. When a dairy sensitive child is doing well and suddenly comes down with congestion, I question the mother carefully. Often the child has either gotten ice cream at a school birthday, or the father, who doesn't believe in this, sabotages the program, or the grandparents took care of the children for the day. It is difficult to change the habits and attitudes of grandparents. One of the remedies that has cough on lying down is STICTA PULMONARIA. It has a short, dry, hacking, incessant, annoying cough. It doesn't necessarily wake the child up. It wakes the parents up. They hate to hear the child coughing. A dose of STICTA makes very appreciative parents. Another cough remedy that I have used,in the past, is ARALIA RACEMOSA. It, too, has the cough on first lying down. But more specifically, it is aggravated after the first sleep. It keeps the parents awake. ARALIA also has asthmatic symptoms, and waking up with wheezing after the first sleep is a good indication for ARALIA. LACHESIS has cough and wheezing at night; the classic sleeping into the aggravation. It is usually later on at night, and the cough doesn't necessarily wake the person up.

A sound-alike remedy, ARANEA DIADEMA, from the spider, has been very helpful in heel pain, pain in the os calcus, as from bone spurs. It is worse, especially on first motion. PULSATILLA and VALERIANA can also be considered in this condition. Patients also talk about a cough excited by tickling or irritation in the throat, which seems to be a generic term in this instance. One has to be more specific. Is it in the pharynx, larynx, trachea, bronchi, chest, etc. SENEGA has a very irritating, scraping sensation high up in the throat and fauces, and it is often used in elderly people with chronic coughs. Nash says it's useful in obstinate coughs of old people with difficult expectoration. It has a peculiar symptom of catarrh of the chest alternating with diarrhea which once led me to the cure of a case. I had a patient with a post-influenzal cough lasting two months. After using many remedies to no avail, I finally cleared the cough with CIMICIFUGA RACEMOSA. This remedy has a very dry, short, cough, with irritation from a dry spot in the larynx and marked aggravation from talking. Spasmodic coughs often yield to HYOSCYAMUS, when other remedies fail, as does frequent urination from bladder irritability. HYOSCYAMUS is similar in its nature to Belladonna, in being able to relieve the spasms of smooth muscle. Likewise, on an emotional plane, IGNATIA will cure the nervous cough of globus, a lump sensation in the throat. This reminds me of a special use of BELLADONNA in the spasm of circular smooth muscle, like bile ducts, where, as Kent says, in gall stone colic, it relaxes the muscles of the bile ducts allowing the stone to pass. Dewey says the same of DIOSCOREA VILLOSA. Remember the distinguishing symptom of DIOSCOREA, being better bending backwards, rather than doubling up as in most other colicky remedies. The patient will be forever grateful. CHOLESTEROLINUM has also been a powerful remedy for me in this regard.

It is most frequent to have a cough that is loose in the morning and tight in the evening or at night. AMMONIUM MURIATICUM has the reverse modalities: dry in the morning and loose in the afternoon and/or evening. AMMONIUM MURIATICUM has several keynotes. One is coldness between the shoulder blades. The symptom I have used it for most frequently is sciatica, better only when lying down. It is similar to DIOSCOREA in this respect. Remember AESCULUS HIPPOCASTANUM for lumbosacral pain, especially when worse standing. Most coughs are worse lying on the left side. I believe there is a physiologic explanation for this. I had a patient who complained of a recurrent severe cough every fall, often progressing to pneumonia. His strongest modality was worse lying on the right. STANNUM METALLICUM cured the case. Remember the sweet tasting sputum of STANNUM which has helped me to find the right remedy in several cases. Most coughs are worse lying down. Try MANGANUM or MANGANUM PHOSPHORICA when better lying down. It also has the hoarseness, worse cold and damp like DULCAMARA, and better lying down. Coughs of gastric origin have been helped with SANGUINARIA, when the cough is better after eructations or passing flatus. VERATRUM ALBUM, from the white hellebore, has a cough coming from deep in the abdomen, better eructations, or with concomitant diarrhea. It is similar to SENEGA in its chest symptoms, with lots of mucus in the bronchial tree and difficult expectoration. It is also one of the few remedies worse in a warm room or on entering a warm room from the cold, like BRYONIA. I remember Dr. Rood discussing VERATRUM VIRIDE, from the white American hellebore. It has rapidly progressing lung congestion, dyspnea, heaviness of the chest, livid and bloated fauces, and drop in blood pressure. I suggest thinking about it for ADULT RESPIRATORY DISTRESS SYNDROME. Remember CASTANEA VESCA for its short, tight, 'ringing', cough; COCCUS CACTI for its spasmodic cough, better in the cold air; CORRALIUM RUBRUM for its continuous "minute gun" type cough during the daytime and whooping-type cough at night. CORRALIUM has a profuse postnasal drip which is a good keynote for this remedy. Recently, a patient of mine had bronchitis. She told me she felt as if there were a long, thick string of mucus hanging down the back of her throat. CORRALIUM, saved the day. STICTA is similar in this regard. ANTIMONIUM SULPHURICUM and LEMNA MINOR also should be considered in postnasal drip. NAPHTHALIUM is another hay fever remedy that is efficacious in long-continued paroxysms of cough, worse at night, with tenacious mucus, and inability to catch the breath, worse inspiration, like BROMIUM, MANGANUM, and RUMEX. MEPHITIS has severe, suffocative coughing spasms at night, with contraction of the glottis, worse expiration. Cough "'till blue in the face" is Boericke's description of MEPHITIS.

I always ask my rheumatic patients to refrain from eating the nightshade family of foods: tomatoes, white potatoes, green peppers, and eggplant. These foods have been associated with arthralgic pains, and I have found this to be true. SOLANUM LYCOPERSICUM, from the tomato, has many arthritic-type symptoms in it. I have successfully used it in right-sided pains, like STICTA. Kent lists it for parasthesias in the ulnar distribution, the inside of the arm and forearm. STICTA is listed for "housemaids knee." It is useful for chronic synovitis of the knee, like CALCAREA FLUORICA, and can be helpful for rheumatism of the small joints, like VIOLA ODORATA and CAULOPHYLLUM. A patient of mine once took CAULOPHYLLUM, herbally, to abort. She developed severe knee pains while taking the remedy, which persisted for a long time thereafter. Add CAULOPHYLLUM to the rubric: knee pain. It has helped me in several other cases. For chronic knee pain try NIACINAMIDE, vitamin B3. I don't know the physiology behind it. Jonathan Wright suggested it at one of his nutritional seminars, and it works.

In fibromyalgia-type symptoms, remember RHAMNUS CALIFORNICA and CASCARA SAGRADA, especially when associated with constipation. In a speech I gave several years ago in Ohio, I talked of SARCOLACTIC ACID as an acute flu remedy. I suggest you also consider it for chronic fatigue syndrome, the type in which there is recurrent sore throat, with achy, flu-type symptoms and malaise. I also talked of FORMIC ACID for chronic arthritis. Consider, too, LACTIC ACID, in the differential for chronic arthritis. I had a patient with a long history of rheumatoid arthritis. She had been on Plaquenil for the past ten years, plus many anti-inflammatants. It had always flared in the winter for which she was given steroids. The most significant part of her past history was recurrent Strep infections throughout childhood. I gave her homeopathic STREPTOCOCCINUM 10M, one dose. She was about thirty percent better from that single dose, despite the heavy allopathic medications. She did not need steroids that winter.

I remember a homeopathic doctor in Michigan who was very successful in treating arthritis with homeopathic bacterial nosodes. Recent literature has shown positive identification of bacteria and viruses in the synovial tissue of arthritic joints. If we could identify this early in the disease, what benefit might we bring to mankind. I am indebted to a patient for helping me find a remedy that I now use more frequently in my practice. She was a thirty-five year-old woman who came to me for chronic acne since her teenage years. She worked in a veterinary clinic and said that sometimes she went home and her urine smelled like cat urine. Now maybe that is not unusual for someone who works in that occupation, but on checking the repertory it led me to VIOLA TRICOLOR. This remedy is quite useful for acne and impetigo-like lesions about the face, especially in children. When chronic or recurrent pustular-type lesions do not respond to the seemingly correct remedies, try a dose of ARSENICUM ALBUM. It has been my 'sheet-anchor' in this circumstance.

Anyone who has had children knows the agony of the COLICKY baby. I have oft quoted the old-time statement that "Homeopathy can rest its laurels alone on ARNICA." Second-best might well be CHAMOMILLA. To lower the pain threshold in any illness, notwithstanding the colicky child, is surely a blessing. CHAMOMILLA has made millions of grateful patients. But alas, when it doesn't work, how can we individualize for the correct remedy? Certainly we can use COLOCYNTH or MAGNESIUM PHOSPHORICA, with flatulent colic, when the knees are pulled up and better with pressure and/or heat on the abdomen. STANNUM METALLICUM saved me once, when other remedies failed. It has that strong symptom of better with hard pressure on the abdomen, especially better walking with the child on your shoulder, so as to put pressure on the child's abdomen. ILLICIUM, from anise, has a wonderful track record for baby colic. Or use DIOSCOREA, when the child is worse bending double and is better arching backwards. I remember DIOSCOREA curing a case of kidney stone colic with the two strong symptoms being pain in the kidney region radiating to the testicles and better bending backwards. Have you ever noticed that colic is usually worse in the evening, just as the father comes home from work? What remedy has child good all day and troublesome all night? If you said JALAPA, then you have probably helped many a colicky baby and frustrated parent.

SINUSITIS seems to be increasing in recent years. It is now thought to be the culprit for asthma and even chronic fatigue syndrome. Two main remedies are KALI IODATUM and ARSENICUM IODATUM, especially when there are thick, acrid nasal discharges. ARSENICUM IODATUM has more glandular involvement and night sweats. KALI IODATUM has more acrid discharges and pain at the root of the nose, pulsating or lancinating in nature, extending to the frontal sinuses. STICTA has dull pressure in the forehead and fullness at the root of the nose, with dry nasal passages. Boericke says COCHLEARIA, from the horseradish, has pressing and boring pains in the forehead "as if the frontal bone would fall out." CINNABARIS, from mercuric sulphide, has pressing pain above the root of the nose and shooting pains in the bones of the orbit "running from the inner to the outer canthus. Several years ago a patient of mine called to say that for the past week he had been experiencing chest discomfort while mowing the lawn. He was a pleasant, mild-mannered, mostly sedentary sixty-six year-old male. I immediately sent him to a cardiologist. Two days later he was recuperating from triple bypass surgery. He has continued to do well. Last spring, he called to ask me to send him another bottle of his allergy medicine. I told him, frankly, that I hadn't remembered him having allergies. He reminded me of the severe sneezing spells he would have every spring and fall, until he started using the granules I gave him. I told him I would look it up and send him some more. To my surprise, the remedy was BOVISTA. This prescription was based on the symptom, "nose obstructed, with watery nasal discharge, only from the left side." He had neglected to mention his allergies in recent visits, since he experienced no troubles while using the remedy. Last month, I treated a woman for acute sinusitis. Her symptoms were: pain in the left frontal and maxillary sinuses, with obstruction of the left nose with fluent discharge at the same time. I gave her BOVISTA and awaited her call. The next day she told my secretary the pain was all relieved.

I thank you for allowing me to share my homeopathic experiences with you. Most of you share the joy and fascination of being able to help people with infinitesimal Homeopathic doses. I often hear excuses that remedies were antidoted by this or that, or that the pharmacy batch was no good to begin with. I quote you Shakespeare, "The fault, dear Brutus, is not in the stars, but in ourselves that we are underlings." Find the correct rubrics and the remedy will cure.