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Treatment with Natrum muriaticum
Treatment with Natrum muriaticum A.
GHOSH,
M.B., B.S.,
M.R.C.P.,
D.C.H.,
D . T . M . & H.
Department of Homveopathic Medicine, The Liverpool Clinic
INTRODUCTIOlq
Natrum muriatieum is a polychrest, beneficial in m a n y chronic ailments and also appears to be a p a n a c e a But to remember all of its indications in isolation is difficult and to treat the individual complaints accordingly, without studying the whole patient, will often lead to failure. After training in orthodox medicine one can visualize th~ patient in relation to the underlying pathology of the disease. With a little effort and reorientation one can picture a person who can be benefited with a remedy, irrespective of the cause of the illness. I n this communication the important characteristics of Natrum muriaticum are grouped under different headings. This m a y help to see the patients who m a y be cured with this remedy. The accompanying diagram depicts such a person. MENTAL
Natrum muriaticum patients are depressed. Their depression is aggravated on consolation (Sepia, Lilium tigrinum). T h e y like to be left alone and cry silently. This is in contrast to the Pulsatilla patients who are comforted and soothed by consolation. An illness m a y be precipitated by mental t r a u m a and shock e.g. bereavement, disappointed affection. While Arnica montana cures ill-health following a physical trauma, Natrum muriaticum treats the disease following mental trauma. GENERAL
Features like thyrotoxicosis I n spite of a good appetite the patients are emaciated and thin, with long slender necks. There is sympathetic overactivity. The patients perspire easily. The skin is greasy. The palms are warm and moist. The pulse is rapid, usually due to sinus taehycardia. Patients m a y complain of palpitations or fluttering of the heart associated with extrasystoles, atrial fibrillation or paroxysmal supraventricular tachycardia. Such patients feel very hot and are worse in a warm room or with local heat. They are better in the open air and after a cold bath.
Features like hypoadrenalism Patients are debilitated and complain of lethargy and lack of energy. They are pale and anaemic. The cause of anaemia is variable. The blood pressure is low or low normal. Craving for salt is present (Phosphorus).
TI~EATMENT
WITI=I ~ A T R U M
MUI~IATICUM
3
Sunrise
Pale
Thin
" 15.R1
Smooth qneasy
1
Warm,~ mo~t
op~dpulse Si.us tac,ycorcllo Extro systole Atrial fibrillation
4
TI-IE BI%ITISI~
Ic[OIYICEOPATICIIC
JOUI%NAL
Dry mucosa (Bryonia) The alimentary tract is dry. The lips are cracked, especially in the middle, and are painful. Due to dryness of the mouth the patients are thirsty and drink water continuously. The anus is cracked and fissured. The stools are dry usually. (A few patients complain of diarrhoea.) The vagina is also dry.
Other features The seashore and sea food make the patients ill. Complaints are worse from sunrise to sunset, notably at 10 in the morning, and are better on pressure, e.g. tight clothing, back support. PARTICULAR
Particular complaints should preferably be treated in conjunction with mental and general characteristics of the patients. Hence under this heading only a few specific symptoms are discussed and the details are avoided.
Headaches Patients often describe their headaches as "a thousand little hammers knocking in the brain". These headaches persist from sunrise to sunset and are worse at 10 in the morning. Headaches related to migraine, frontal sinus inflammation, eye strains, and in anaemic school girls, respond well to Natrum muriaticum. Due to the possibility of aggravation of symptoms it is suggested t h a t this remedy should be avoided during an a t t a c k of headache.
Eyes Migrainous visual disturbances, eye strain, stricture of lachrymal duct with suppuration and incipient cataract can be relieved with this remedy.
Back and extremities Backache and arthritis with a desire for a firm support which are worse with heat and better with cold are alleviated with this potentiated salt. This remedy is indicated in numbness and tingling of fingers, toes and also of the tongue, lips and nose.
Skin D r y eczema of flexures, margins of hairy scalp and behind the ears, hangnails, urticaria and alopecia are treatable with Natrum muriaticum. PATIENTS
Patient 1 (Mrs. D.J.S.) This 45-year-old female has rheumatic valvular heart disease. Her pulmonary arterial pressure is normal and her heart is well compensated on Digoxin 0.25 mg twice a day. She is also anaemic because of menorrhagia and is treated with oral iron and Vitamin C. I n February 1976, she complained of fainting attacks. She went dizzy on standing up. She felt as if her head was in the air and t h a t she was walking on cotton wool. She felt hot, perspired profusely and kept all the windows open when the rest of the family felt cold. H e r palms were warm and moist. She
TREATMENT
WITH
I~ATRUI~
MURIATICUM
5
had attacks of palpitations. She was of a thin build with a long neck. I n addition to this thyrotoxie feature she looked pale and complained of lethargy. She also had headaches every morning. Her haemoglobin was 12.5 grams per cent with Packed Cell Volume of 39 per cent and M.C.I-I.C. 32 grams per dl. Thyroid function tests, serum electrolytes and urea were normal. Valium and Inderal did not relieve her of these symptoms. I n view of the possibility of menopausal syndrome ttarmogen was tried, without a n y effect. Eight months after the onset of her present illness homceopathic treatment was considered. I n October 1976 she was prescribed Natrum muriaticum 30c, one tablet three times a day. She discontinued this treatment after one week as she felt worse. But a cure followed this aggravation.
Patient 2 (Mrs. J.B.) I n J a n u a r y 1976, this 82-year-old widow, who lives alone and has been depressed since her husband's death six years ago, complained that she felt very hot and had profuse perspiration. I n her own words she was "wringing wet". Her skin was smooth and moist. I n spite of a good appetite she had lost weight and looked emaciated. Her neck was thin. She was tired, lacked energy and looked pale. Her haemoglobin was 10.2 grams per cent. Peripheral blood film and bone marrow showed megaloblastic anaemia. There was no free acid in her stomach. Antibodies to gastric parietal cells were present. On these results a diagnosis of pernicious anaemia was made. I n April 1976 treatment with cytamen injections was commenced. But the patient continued to remain ill. In July 1976, she was given Natrum muriaticum 30c, 1 tablet three times a day, for two weeks. After this treatment, she felt normal and had no complaints. She had recurrence of her symptoms in October 1976 and June 1977. On each occasion the same treatment was repeated with success.
Patient 3 (Mrs. E.M.) This 66-year-old female suffered from chronic ill health for the past 25 years. She was treated for pulmonary and intestinal tuberculosis from 1972 to 1974. When she was seen in July 1976 she was depressed and h ~ l no smile on her face. She was thin, with a long neck. Her skin was smooth, she felt lethargic and lacked energy. She was pale, with a haemoglobin of 11.4 grams per cent and M.C.H.C. of 32 grams per dl. Serum B12 and folate were normal. She had recurrent diarrhoea and vomiting and needed Lomotil and Stemetil. Often she had sickly headaches. She also complained of numbness and tingling of her left hand and left little finger. This was associated with clicking in the neck. X-ray of cervical spine showed degenerative disc changes and osteoarthritis of C5, C6 and C7. A cervical collar gave her only temporary relief. She was given Natrum muriaticum 30c, one tablet three times a day, for four weeks. The effect of this treatment was inconchisive. But in October 1976, the patient realized that she was not as well as she had been in the previous three months and asked for a repeat prescription. Since then she is a different person. She smiles, has more energy, has dispensed with her cervical collar and does not ask for Lomotil and Stemetil any more.
6
THE
BRITISH
/{OM(EOPATI~IC
JOURNAL
Patient 4 (Mr. J.W.) This 70-year-old patient had enucleation of the right eye in September 1975, because of glaucoma which followed retinal vein thrombosis. H e had lost his vision in the left eye in childhood, as the result of an injury. I n April 1976, he complained of pain in the left supraorbital region and vertex. Analgesics gave him t e m p o r a r y relief. A definite cause for the pain could not be established. He was a m a n of thin build and smooth skin. In view of the possibility of eye strain in an a t t e m p t to see in spite of his blindness, he was prescribed Natrum muriaticum 30c, one tablet three times a day, for two weeks in September 1976. This treatment relieved the patient of his pain.
Patient 5 (Mr. S.M.) I n December 1976, this 60-yeax-old m a n was involved in a car accident and fractured his fourth rib on the left side and third and fourth metatarsal bones on the right foot. He developed a left pneumothorax and was treated in an intensive care unit. Though he recovered from his physical injuries he continued to be tense, anxious and irritable and suffered from insomnia. Valium gave him transient relief. I t was considered t h a t his illness was precipitated b y mental t r a u m a subsequent to the car accident. He was prescribed Natrum muriaticum 10iV[, one tablet three times in one day. Since then he is asymptomatic and is back to his normal self. DISCUSSIO~I
I n the orthodox management of a case, treatment is directed towards the underlying pathology of the disease. When the pathological process cannot be reversed, symptomatic therapy is offered which gives relief only for a short time and has to be continued therefore for an indefinite period. This line of approach m a y not be always successful. I n patient 1 the most likely diagnosis was thyrotoxicosis. When thyroid function tests proved normal, the patient was treated symptomatically, without success. The symptoms of patient 2 could not be explained and she was allowed to live with her complaints. I n patient 3, depression, general ill health, diarrhoea and vomiting were attributed to pulmonary and intestinal tuberculosis. H e r tuberculosis was controlled with anti-tubercular drugs, but her complaints persisted. She got only transient relief with Lomotil and Stemetil. Only symptomatic treatment could be offered to patient 4 for his headaches, and to patient 5 for his psychological complaints. I n contrast to an orthodox physician a homceopath, whose attitude is different, attempts to cure the patient irrespective of the underlying cause. All the above patients were treated successfully with Natrum muriaticum. Chief indications for the use of this remedy were as follows (Table). All the five patients were of a thin build with slender necks. Features simulating thyrotoxicosis were present in patients 1 and 2 and hypoadrenalism in patient 3. The first three patients were anaemic and lethargic. I n patient 4 the headaches were attributed to eye-strain. Complaints of patient 5 resulted from mental trauma. Para~sthesia of fingers was present in patient 3. Often, orthodox management of a clinical problem only alleviates symptom, which recur on cessation of the treatment. Hence patients see the need for the drugs. On the other hand, h o m e o p a t h i c treatment gives permanent or prolonged relief, with the result that patients forget all about the diseases the cure and the h o m e o p a t h . This was noted in patient 3 who realized the
TREATMENT WITH :NATRUM I~IURIATICU~ TABLE--CHIEF
II~DICATIOI~S
FOR
NATI~UI~I
I~URIATICUI~I
Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 ~ENTAL
Depression Mental trauma
-5
-5 -5
GEN]ERA L
Features like thyrotoxieosis
Thin Increased perspiration Skin--greasy Palms--warm and m o i s t Pulse--rapid F e e l s hot
+ + 5 + + +
+ + -5 -5
-5 5
-5 +
+
-5
-5
-5
+
+
l~eatures like hypoadrenalism
Lethargy Anaemia L o w B.P. S a l t craving
+ +
Dry mueosa
Lips dry and cracked Thirsty Dry stools Dry vagina Others
Worse-seashore and s e a f o o d Sunrise to sunset (10 a.m.) Better on p r e s s u r e PARTICULARS
Headache Eye strain Backache/Arthritis Paraesthesia Skin-Eczema/Urticaria/Alopecia
-5
-5
-5 -5
-5
efficacy of N a t r u m muriaticum only after recurrence of her symptoms. P a t i e n t 4 had forgotten his headaches a n d cure till he was reminded of these several weeks later. The most difficult situation arises when the homceopathic remedy causes aggravation. P a t i e n t 1 returned the t a b l e t s of N a t r u m muriaticum because t h e y made her worse. Though cure followed soon after, she has no t h a n k s for homceopathy. She thinks her recovery was spontaneousr A homceopath has to s t u d y his patients in great detail. I n the modern medical practice, this is not always possible, due to lack of time. While selecting N a t r u m muriaticum one should remember the salient features of this remedy. W i t h increasing experience it is then possible to select the patients who could benefit from this. I t is suggested t h a t in thin emaciated persons with slender necks, features of N a t r u m muriaticum should be looked for. SUMMARY
Characteristic features of N a t r u m muriaticum and the successful t r e a t m e n t of five patients with this remedy are discussed. I wish to t h a n k Dr. L. G. C. Martin for his encouragement in preparing the manuscript.
GHOSH,
M.B., B.S.,
M.R.C.P.,
D.C.H.,
D . T . M . & H.
Department of Homveopathic Medicine, The Liverpool Clinic
INTRODUCTIOlq
Natrum muriatieum is a polychrest, beneficial in m a n y chronic ailments and also appears to be a p a n a c e a But to remember all of its indications in isolation is difficult and to treat the individual complaints accordingly, without studying the whole patient, will often lead to failure. After training in orthodox medicine one can visualize th~ patient in relation to the underlying pathology of the disease. With a little effort and reorientation one can picture a person who can be benefited with a remedy, irrespective of the cause of the illness. I n this communication the important characteristics of Natrum muriaticum are grouped under different headings. This m a y help to see the patients who m a y be cured with this remedy. The accompanying diagram depicts such a person. MENTAL
Natrum muriaticum patients are depressed. Their depression is aggravated on consolation (Sepia, Lilium tigrinum). T h e y like to be left alone and cry silently. This is in contrast to the Pulsatilla patients who are comforted and soothed by consolation. An illness m a y be precipitated by mental t r a u m a and shock e.g. bereavement, disappointed affection. While Arnica montana cures ill-health following a physical trauma, Natrum muriaticum treats the disease following mental trauma. GENERAL
Features like thyrotoxicosis I n spite of a good appetite the patients are emaciated and thin, with long slender necks. There is sympathetic overactivity. The patients perspire easily. The skin is greasy. The palms are warm and moist. The pulse is rapid, usually due to sinus taehycardia. Patients m a y complain of palpitations or fluttering of the heart associated with extrasystoles, atrial fibrillation or paroxysmal supraventricular tachycardia. Such patients feel very hot and are worse in a warm room or with local heat. They are better in the open air and after a cold bath.
Features like hypoadrenalism Patients are debilitated and complain of lethargy and lack of energy. They are pale and anaemic. The cause of anaemia is variable. The blood pressure is low or low normal. Craving for salt is present (Phosphorus).
TI~EATMENT
WITI=I ~ A T R U M
MUI~IATICUM
3
Sunrise
Pale
Thin
" 15.R1
Smooth qneasy
1
Warm,~ mo~t
op~dpulse Si.us tac,ycorcllo Extro systole Atrial fibrillation
4
TI-IE BI%ITISI~
Ic[OIYICEOPATICIIC
JOUI%NAL
Dry mucosa (Bryonia) The alimentary tract is dry. The lips are cracked, especially in the middle, and are painful. Due to dryness of the mouth the patients are thirsty and drink water continuously. The anus is cracked and fissured. The stools are dry usually. (A few patients complain of diarrhoea.) The vagina is also dry.
Other features The seashore and sea food make the patients ill. Complaints are worse from sunrise to sunset, notably at 10 in the morning, and are better on pressure, e.g. tight clothing, back support. PARTICULAR
Particular complaints should preferably be treated in conjunction with mental and general characteristics of the patients. Hence under this heading only a few specific symptoms are discussed and the details are avoided.
Headaches Patients often describe their headaches as "a thousand little hammers knocking in the brain". These headaches persist from sunrise to sunset and are worse at 10 in the morning. Headaches related to migraine, frontal sinus inflammation, eye strains, and in anaemic school girls, respond well to Natrum muriaticum. Due to the possibility of aggravation of symptoms it is suggested t h a t this remedy should be avoided during an a t t a c k of headache.
Eyes Migrainous visual disturbances, eye strain, stricture of lachrymal duct with suppuration and incipient cataract can be relieved with this remedy.
Back and extremities Backache and arthritis with a desire for a firm support which are worse with heat and better with cold are alleviated with this potentiated salt. This remedy is indicated in numbness and tingling of fingers, toes and also of the tongue, lips and nose.
Skin D r y eczema of flexures, margins of hairy scalp and behind the ears, hangnails, urticaria and alopecia are treatable with Natrum muriaticum. PATIENTS
Patient 1 (Mrs. D.J.S.) This 45-year-old female has rheumatic valvular heart disease. Her pulmonary arterial pressure is normal and her heart is well compensated on Digoxin 0.25 mg twice a day. She is also anaemic because of menorrhagia and is treated with oral iron and Vitamin C. I n February 1976, she complained of fainting attacks. She went dizzy on standing up. She felt as if her head was in the air and t h a t she was walking on cotton wool. She felt hot, perspired profusely and kept all the windows open when the rest of the family felt cold. H e r palms were warm and moist. She
TREATMENT
WITH
I~ATRUI~
MURIATICUM
5
had attacks of palpitations. She was of a thin build with a long neck. I n addition to this thyrotoxie feature she looked pale and complained of lethargy. She also had headaches every morning. Her haemoglobin was 12.5 grams per cent with Packed Cell Volume of 39 per cent and M.C.I-I.C. 32 grams per dl. Thyroid function tests, serum electrolytes and urea were normal. Valium and Inderal did not relieve her of these symptoms. I n view of the possibility of menopausal syndrome ttarmogen was tried, without a n y effect. Eight months after the onset of her present illness homceopathic treatment was considered. I n October 1976 she was prescribed Natrum muriaticum 30c, one tablet three times a day. She discontinued this treatment after one week as she felt worse. But a cure followed this aggravation.
Patient 2 (Mrs. J.B.) I n J a n u a r y 1976, this 82-year-old widow, who lives alone and has been depressed since her husband's death six years ago, complained that she felt very hot and had profuse perspiration. I n her own words she was "wringing wet". Her skin was smooth and moist. I n spite of a good appetite she had lost weight and looked emaciated. Her neck was thin. She was tired, lacked energy and looked pale. Her haemoglobin was 10.2 grams per cent. Peripheral blood film and bone marrow showed megaloblastic anaemia. There was no free acid in her stomach. Antibodies to gastric parietal cells were present. On these results a diagnosis of pernicious anaemia was made. I n April 1976 treatment with cytamen injections was commenced. But the patient continued to remain ill. In July 1976, she was given Natrum muriaticum 30c, 1 tablet three times a day, for two weeks. After this treatment, she felt normal and had no complaints. She had recurrence of her symptoms in October 1976 and June 1977. On each occasion the same treatment was repeated with success.
Patient 3 (Mrs. E.M.) This 66-year-old female suffered from chronic ill health for the past 25 years. She was treated for pulmonary and intestinal tuberculosis from 1972 to 1974. When she was seen in July 1976 she was depressed and h ~ l no smile on her face. She was thin, with a long neck. Her skin was smooth, she felt lethargic and lacked energy. She was pale, with a haemoglobin of 11.4 grams per cent and M.C.H.C. of 32 grams per dl. Serum B12 and folate were normal. She had recurrent diarrhoea and vomiting and needed Lomotil and Stemetil. Often she had sickly headaches. She also complained of numbness and tingling of her left hand and left little finger. This was associated with clicking in the neck. X-ray of cervical spine showed degenerative disc changes and osteoarthritis of C5, C6 and C7. A cervical collar gave her only temporary relief. She was given Natrum muriaticum 30c, one tablet three times a day, for four weeks. The effect of this treatment was inconchisive. But in October 1976, the patient realized that she was not as well as she had been in the previous three months and asked for a repeat prescription. Since then she is a different person. She smiles, has more energy, has dispensed with her cervical collar and does not ask for Lomotil and Stemetil any more.
6
THE
BRITISH
/{OM(EOPATI~IC
JOURNAL
Patient 4 (Mr. J.W.) This 70-year-old patient had enucleation of the right eye in September 1975, because of glaucoma which followed retinal vein thrombosis. H e had lost his vision in the left eye in childhood, as the result of an injury. I n April 1976, he complained of pain in the left supraorbital region and vertex. Analgesics gave him t e m p o r a r y relief. A definite cause for the pain could not be established. He was a m a n of thin build and smooth skin. In view of the possibility of eye strain in an a t t e m p t to see in spite of his blindness, he was prescribed Natrum muriaticum 30c, one tablet three times a day, for two weeks in September 1976. This treatment relieved the patient of his pain.
Patient 5 (Mr. S.M.) I n December 1976, this 60-yeax-old m a n was involved in a car accident and fractured his fourth rib on the left side and third and fourth metatarsal bones on the right foot. He developed a left pneumothorax and was treated in an intensive care unit. Though he recovered from his physical injuries he continued to be tense, anxious and irritable and suffered from insomnia. Valium gave him transient relief. I t was considered t h a t his illness was precipitated b y mental t r a u m a subsequent to the car accident. He was prescribed Natrum muriaticum 10iV[, one tablet three times in one day. Since then he is asymptomatic and is back to his normal self. DISCUSSIO~I
I n the orthodox management of a case, treatment is directed towards the underlying pathology of the disease. When the pathological process cannot be reversed, symptomatic therapy is offered which gives relief only for a short time and has to be continued therefore for an indefinite period. This line of approach m a y not be always successful. I n patient 1 the most likely diagnosis was thyrotoxicosis. When thyroid function tests proved normal, the patient was treated symptomatically, without success. The symptoms of patient 2 could not be explained and she was allowed to live with her complaints. I n patient 3, depression, general ill health, diarrhoea and vomiting were attributed to pulmonary and intestinal tuberculosis. H e r tuberculosis was controlled with anti-tubercular drugs, but her complaints persisted. She got only transient relief with Lomotil and Stemetil. Only symptomatic treatment could be offered to patient 4 for his headaches, and to patient 5 for his psychological complaints. I n contrast to an orthodox physician a homceopath, whose attitude is different, attempts to cure the patient irrespective of the underlying cause. All the above patients were treated successfully with Natrum muriaticum. Chief indications for the use of this remedy were as follows (Table). All the five patients were of a thin build with slender necks. Features simulating thyrotoxicosis were present in patients 1 and 2 and hypoadrenalism in patient 3. The first three patients were anaemic and lethargic. I n patient 4 the headaches were attributed to eye-strain. Complaints of patient 5 resulted from mental trauma. Para~sthesia of fingers was present in patient 3. Often, orthodox management of a clinical problem only alleviates symptom, which recur on cessation of the treatment. Hence patients see the need for the drugs. On the other hand, h o m e o p a t h i c treatment gives permanent or prolonged relief, with the result that patients forget all about the diseases the cure and the h o m e o p a t h . This was noted in patient 3 who realized the
TREATMENT WITH :NATRUM I~IURIATICU~ TABLE--CHIEF
II~DICATIOI~S
FOR
NATI~UI~I
I~URIATICUI~I
Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 ~ENTAL
Depression Mental trauma
-5
-5 -5
GEN]ERA L
Features like thyrotoxieosis
Thin Increased perspiration Skin--greasy Palms--warm and m o i s t Pulse--rapid F e e l s hot
+ + 5 + + +
+ + -5 -5
-5 5
-5 +
+
-5
-5
-5
+
+
l~eatures like hypoadrenalism
Lethargy Anaemia L o w B.P. S a l t craving
+ +
Dry mueosa
Lips dry and cracked Thirsty Dry stools Dry vagina Others
Worse-seashore and s e a f o o d Sunrise to sunset (10 a.m.) Better on p r e s s u r e PARTICULARS
Headache Eye strain Backache/Arthritis Paraesthesia Skin-Eczema/Urticaria/Alopecia
-5
-5
-5 -5
-5
efficacy of N a t r u m muriaticum only after recurrence of her symptoms. P a t i e n t 4 had forgotten his headaches a n d cure till he was reminded of these several weeks later. The most difficult situation arises when the homceopathic remedy causes aggravation. P a t i e n t 1 returned the t a b l e t s of N a t r u m muriaticum because t h e y made her worse. Though cure followed soon after, she has no t h a n k s for homceopathy. She thinks her recovery was spontaneousr A homceopath has to s t u d y his patients in great detail. I n the modern medical practice, this is not always possible, due to lack of time. While selecting N a t r u m muriaticum one should remember the salient features of this remedy. W i t h increasing experience it is then possible to select the patients who could benefit from this. I t is suggested t h a t in thin emaciated persons with slender necks, features of N a t r u m muriaticum should be looked for. SUMMARY
Characteristic features of N a t r u m muriaticum and the successful t r e a t m e n t of five patients with this remedy are discussed. I wish to t h a n k Dr. L. G. C. Martin for his encouragement in preparing the manuscript.