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The case history that I am going to tell you about this time is quite different from most histories that we, as homeopaths, tend to discuss. It has to be said that not every case that we see can be solved with just one or two remedies. A large part of a homeopath's work consists of patients with complex and chronic diseases. In many instances, the process of treatment can be likened to the peeling of an onion. Every remedy, that acts on the patient, reveals a new picture which is then studied again and treated on its merits.

Olive first came to see me twelve months ago. In common with many patients consulting homeopaths, she was desperate to find a solution to her problems. Her history started five years previously when she was diagnosed as suffering from hypothyroidism. Shortly after commencing thyroid hormone, she developed three damaging and debilitating disorders in rapid succession. First, her eyes started to become bloodshot and painful, then her muscles seized up with terrible aching and weakness especially in the arms and legs. Finally, she developed severe headaches. Her doctor found her to have very abnormal blood tests, referred her urgently to a rheumatologist who diagnosed scleritis of the eye, polymyalgia rheumatica and temporal arteritis. In order to preserve her sight, which she was in danger of losing due to the inflammation in the arteries supplying the eyes, she was commenced on very high doses of steroid tablets (fifty milligrams of prednisolone).

Over the intervening five years, she tried to reduce the steroids on many occasions. Her doctors were very keen for her to drop the dose because of the damaging side effects relating to long term steroid intake. Unfortunately, every time she went below 15mg, her condition would relapse. In desperation, the specialist prescribed low doses of various cytotoxic agents of the type used in chemotherapy for cancer, in the hope that they would have a so-called 'steroid-sparing' effect and allow her to break the fifteen milligram barrier. Unfortunately, all these medications made Olive feel very unwell and she was unable to continue them. When she arrived in my consulting room, her main complaints were of weight gain, breathlessness and terrible tiredness as well as recurrent bouts of eye pain.

As well as the above symptoms, Olive turned out to be fussy, a perfectionist, always warm blooded and a tummy sleeper. She liked most foods but not fat. Her mother died of renal failure and her father of cancer. She revealed her own personal theory that the onset of her illness was related to severe shock that she had received just before. She had been involved in quite a serious road traffic accident and although not injured herself, had been left very shaken for some considerable time.

Analysing her case, she had characteristics of several major remedies and was suffering from an auto immune disease. For these reasons I wished to prescribe Carcinosin but preceded it by three doses of high potency Aconite, the ultimate homeopathic remedy for shock. This approach can be useful to try and overcome the influences of long past events.

One month later, her breathing was much improved, she had lost half a stone in weight and she had reduced the steroids to 12.5 mg. for the first time in five years! On the down side she had considerable stiffness and quite a lot of cramp and spasm. She had recently had a fad on smoked foods and her conversation was very much focused on a local situation which she felt to be very unjust. I decided to prescribe Causticum which is excellent for stiffness, likes smoked things and is deeply committed to the cause of social justice. I also obtained a low dose dilution of Cortisone which I had seen in the literature to be useful on occasion to neutralise steroid side effects.

A further month on, Olive was very much better in general, with less stiffness and far better energy levels. On the steroid side, she had reduced to 10mg. However, she had had a new bout of scleritis and was worried that her eye specialist would want to increase the steroids again. I therefore arranged for her to receive some Euphrasia mother tincture eye drops for use four times daily. She continued the homeopathic Cortisone and nothing else.

The following month things were not going well. She had remained on 10 mg of Prednisolone but was now afflicted with severe pain, burning in nature, down the left leg. She also had swelling of the right wrist and hand with stabbing neuralgic pains radiating up the fingers. This was similar to a pain she had had four years previously and I wondered if it represented a transient return of old symptoms. This is something that can occur when a patient is under homeopathic treatment and can indicate that the remedy given is ageing. She was feeling very fearful and the fear was giving her an "anxious tummy". These symptoms added up to Kali carbonicum and she was prescribed three doses as well as continuing the "Cortisone".

Olive returned six weeks later and was coming out of the doldrums. She was now down to 10 mg! alternating with 8.5 mg and feeling quite a lot better. The leg pain had settled but the wrist was still painful, hot and puffy, better for cold applications. Most wonderful of all, her eyes had settled completely within a month of commencing the Euphrasia eye drops. This improvement without high dose steroids had not happened with her since the onset of the illness five years before and she was delighted. I decided to prescribe Apis 30c 3 doses for the joint symptoms and continued the other remedies as before.

I did not see Olive for two months after the Apis. When she came, the wrist had all but settled, she had reduced the steroids further and her eyes were fine. However, she was in a state which I had never before seen in her. A month previously she had moved house and she was very unhappy. The new house was one that her husband had like very much but that she was not so keen on.

Since the move she had been increasingly low in spirits and now did not want to talk to anyone, did not even want to get up in the morning. She was despairing and actually stated that she wished at times that she would not wake in the morning. However, there was also a definite air of resentment in the way that she spoke and so, rather than give her pure Aurum metallicum, the archetypal despair remedy, I prescribed Aurum natronatum muriacticum, a compound salt of Aurum and the resentment remedy Natrum muriaticum.

Two months later Olive was back. She was quite recovered in her spirits and had come to terms with the move. Her steroids were now down to 7.5mg daily, half the original dose. There was no recurrence of her original symptoms in the limbs or the eyes. However, she was experiencing a change in her bowels with intermittent loose motions, colicky pain and wind associated with bloating but no appetite loss or weight loss. The symptoms made her feel angry and irritable. She had been to see a bone specialist who told her that the prolonged steroid usage had had a very deleterious effect on her spine and that she now had osteoporosis. Olive was very angry that she had to be on steroids for so long. I decided on Colocynthis for the bowels symptoms together with the angry reaction and irritability and await developments.

This case, though not stunningly exciting, is none the less an important demonstration of how homoeopathic treatment sometimes has to progress. One cannot always find THE REMEDY straight away for a patient, particularly in adults with chronic disease. Instead the prescription of a remedy at a medium potency for the symptoms that are surfacing at the time allows the case to unfold so that, slowly but surely, progress can be made. By supporting Olive's immune system with the remedies, she had been able to reduce the steroid tablets far below the level she has previously been able to achieve. Her rheumatologist is very surprised and has expressed an interest in the treatment she has been using! The ophthalmologist is also very pleased because this is the longest period free of scleritis for years. Homeopaths often feel that their remedies do not work or work less well in patients who are taking steroids. This has not been my experience with Olive and it is my hope that, by continued patient work along the same lines, we will be able to restore Olive to full health and stop the steroid altogether. Sadly, though, I do not think that homoeopathy will restore Olive's osteoporotic spine - that is being treated with a conventional bone building drug, which is the best treatment that we have at the present.