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Homeopathy (2007) 96, 258–269r 2007 The Faculty of Homeopathy

doi:10.1016/j.homp.2007.08.013, available online at http://www.sciencedirect.com

CLINICAL

Aurum muriaticum natronatum—four casereports

Raymond Sevar�

26 Whiteclosegate, Carlisle, Cumbria CA3 OJD, UK

�CorrespondCarlisle, CumE-mail: RaymReceived 2422 August 2

Four cases treated with Aurum muriaticum natronatum are presented using thepatients’ own words; two cases of fibromyoma of uterus and thyroid disorders, andtwo of eczema and depression with suicidal ideation after disappointed romantic love.The case analyses and management are discussed and distilled into the materia medicaof Aurum muriaticum natronatum with the creation of a heuristic. Homeopathy (2007)96, 258–269.

Keywords: Aurum muriaticum natronatum; fibromyoma uterus; thyroid; eczema;depression; suicidal thoughts; disappointed love; materia medica; heuristic

IntroductionThese case reports explore the author’s growing in

understanding of Aurum muriaticum natronatum as animportant homeopathic medicine gained from theprocess of treating four people struggling with deepand complex physical and emotional pathology, from1995 to 2007. The cases reflect the reality of privatepractice homeopathy in that they are not perfect inmanagement or length of follow-up. All the fourpatients refused to allow me to write to their GP orspecialists—this made some aspects of managementdifficult. Also, for this reason precise details ofinvestigation results are lacking as they were reluctantto ask for copies from their GPs.The analysis of each case is given as the case

develops. Heuristics (empirical short cuts used to assesscomplex situations to form conclusions and/ormake decisions) are used as appropriate. An heuristicfor the prescription of Aurum muriaticum natronatumis presented. Symptoms are given in the patientsown words y represents a gap in spontaneousnarrative.

ence: Raymond Sevar, 26 Whiteclosegate,bria CA3 OJD, UK.ondsevar@aol.com

November 2006; revised 22 August 2007; accepted007

Case1: fibromyoma, goitre andthyrotoxicosis‘‘S’’ is a 27-year-old woman with green eyes and long

brown hair.

First consultation October 1995

‘‘For the last 2 years I have been so tired all the time. Igot pains in my tummy and when I felt I found this bighard lump. I thought I had cancer. My doctor found ahuge fibroid in my uterus. y I was put on hormoneinjections for 11 months and the fibroid got smaller.

y The first gynaecologist said that the fibroid was sobig that I would need a hysterectomy. But I want tohave children. The gynaecologist said if the fibroidwere to shrink a lot (to the size of an orange) then hemay be able to operate and remove the fibroid butleave my uterus—but there was a risk that my uteruswould be damaged while trying to take out the fibroidand might have to be removed anyway. y Mymother had to have a hysterectomy because she had ahuge fibroid.

y I have only had 2 periods since the hormoneinjections stopped 6 months ago and they have beenso painful the first day and I lose big clots for 6 days.

y Then my thyroid started swelling and my heartwas racing and I got so hot all the time. My GP saidmy pulse was twice the speed it should be. I was puton thiouracil and thyroxine and this seemed to sortout my thyroid but my fibroid grew as big as ever itwas before the hormone injections.

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y Before it all started I was supposed to be a witnessin a court case and got so worried about it. And justwhen I had wound myself up about going in thewitness box the case got postponed 5 times. y Icouldn’t sleep and kept getting big waves of panicattacks y With the panic attacks I would getstabbing pains in my chest and my arms would gonumb y As soon as my doctor said it was just panicand not my heart I was fine.

y I’ve had the same boyfriend since I was 15. He isthe love of my life. He is from Australia and he wantsto go back.

(Begins to cry and keeps on crying). y He haswanted to go back to Australia for 6 years, but it hasbecome a big issue in the last 2 years y I can’t leavemy mother because I am worried about her, and I amscared to go.

y I hate the number 3, I will never pick 3 in a lotteryand I will never do the same thing 3 times in a row y

I am really scared of spiders and a bit afraid of beingalone in the dark, but I can sleep in the house alone.’’

On examination: Uterus huge—extends to 2 cmabove umbilicus and is as hard as stone; large firmgoitre, clinically euthyroid.

Analysis October 1995

The focus of pathology is the huge, hard fibroid ofuterus. Her other physical pathology—goitre andthyrotoxicosis—is suppressed by conventional drugs(thiouracil and thyroxine). Her illness appears to havebeen precipitated by emotional strain of disappoint-ment of her romantic love and sustained anxiety. Thisis similar to Ignatia amara or Natrum muriaticum butthese are not specifically indicated in her uterinepathology (see Graph 1).

Rubrics (Complete Repertory, Van Zandvoort):

�

Gr

Co

Female; TUMORS; general; fibroma; uterus (87)

� Female; TUMORS; general; fibroma; hard, stony,

uterus (2)

� External Throat; GOITRE (150) � Mind; ANXIETY (565) � Mind; AILMENTS from; love, disappointed, un-

happy (40).

aph 1 Repertorisation of Case 1 at initial consultation. (MacRepe

mplete Millennium Repertory of Van Zandvoort).

Homeopathic treatment

Aurum muriaticum natronatum 200 cH 1 dose, then6 cH twice a day.Continue thyroid drugs.

October 1995–1997

Aurum muriaticum natronatum 6 cH twice a day wascontinued from 26 October 1995 till 3 May 1996 andthe fibroid decreased in size from that of a watermelonto 5 cm diameter. The hard goitre remained un-changed. Results of thyroid function tests on 21November 1995: TSH 3.8 (normal 0.2–3.0mU/l), freeT4 22 (normal 12–28 pmol/l). So I stopped herthiouracil and thyroxine, then the goitre receded (shecontinued on Aur-m-n 6 cH b.d.) becoming unpalpable.In June 1996 the fibromyoma was surgically removed,leaving the uterus intact. Post-operative complicationsof deep vein thrombosis and pulmonary embolus weretreated by Heparin infusion then Warfarin for 3months. Pre- and post-operative treatments of Aurummuriaticum natronatum 200 cH drops were prescribed.

Consultation November 1997

‘‘I have been really happy since the operation. I havea new boyfriend and we are getting married next year.y In the last 2 months I have become ill again but itfeels different. y I am really anxious and tremblingall the time y My voice trembles and my arms andlegs and hands tremble y It all gets better when I sitdown y The anxiety and trembling go away when Isit down, but I am too restless to sit down y It is notlike the old panic attacks. I am just anxious andtrembling all the time y I am really hot all the timeand a bit sweaty. I am hot even when others are coldy The anxiety and trembling comes in attacks butthe heat is there all the time y My periods areregular and normal now. I bleed for 3 days every 28days.’’

On examination: Skin very warm, goitre: big soft andhot, hot red face, pulse bounding 120 regular, palmshot and sweaty, no lid lag, no proptosis.

rtory Professional version 6.1, expert analysis settings using

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Analysis November 1997

There has been a shift in pathology to the thyroidafter the excision of the fibroid of uterus. Clinically sheis hyperthyroid. The form of anxiety is different andamelioration of anxiety by sitting is a striking andunusual modality in someone who is also physicallyrestless (see Graph 2).

Rubrics:

�

GrMil

thy

Mind; ANXIETY; sitting; amel., all anxiety disap-pears (1)

� External Throat; GOITRE (150) � Generalities; HEAT; sensation of (172) � Generalities; RESTLESSNESS, physical (149).

Homeopathic treatment

Iodum 200 cH 1 dose daily for 3 days, check freeT4/T3 and TSH now and repeat in 1 month. If T4/T3is still high, to take Iodum 12 cH daily until euthyroid.

March 1998

The first thyroid function tests confirmed thyrotox-icosis (before treatment with Iodum 200 cH); thesecond tests were normal (1 month after Iodum200 cH 1 dose). Symptomatic improvement beganwithin 24 h of taking Iodum 200 cH. The anxiety andtrembling stopped after 7 days and the sensation ofheat resolved gradually in 4 weeks.

Comments

The patient’s initial huge, stony-hard fibromyoma ofuterus was suppressed by synthetic progestagens andshe developed a hyperthyroid goitre. When her thyroidwas suppressed by thiouracil and thyroxine the fibroidrecurred. Both the fibroid and the thyroid respondedwell to Aur-m-n—the fibroid gradually shrank from thesize of a watermelon to 5 cm diameter and her thyroidbecame normal in function and size. I anticipated thather thyrotoxic goitre would recur after surgicalremoval of her small fibroid. After discussion thepatient decided to proceed with uterine surgery,because she wished to be a mother and was willing torisk a relapse of hyperthyroidism.The potencies of 200 cH and then 6 cH twice a day

for a long time of Aurum muriaticum natronatum were

aph 2 Repertorisation of Case 1, November 1997. (MacRepertory Plennium Repertory of Van Zandvoort).

chosen because there was a clear emotional componentplus marked physical pathology (a prescribing heur-istic learned from Dr Roger Morrison). She took 6 cHtwice daily for three menstrual cycles while her fibroidgradually shrank and then 6 cH twice daily for 10 dayspre-menstrual (when her fibroid swelled) for the nextfour cycles. Now I would have begun her treatmentwith Q/LM 1 potency 2 drops in water daily becauseexperience and clinical audit confirm that the Q/LMpotencies give a smooth, deep, quick and sustainedresponse in the majority of my cases.The relapse of hyperthyroidism following surgical

removal of the fibroid presented with a differentclinical state, with anxiety completely ameliorated bysitting down even though she was still physicallyrestless, a unique symptom of Iodum.

Case 2:Hysterectomy for fibromyomaand thyroid cyst‘‘A’’ is a 48-year-old woman with brown eyes and

brown curly hair.

First consultation December 1995

‘‘A year ago I had a total abdominal hysterectomybecause I had a huge fibroid in my uterus, and I havenot been well since y I am tired and miserable anddon’t sleep well y The fibroid was enormous, like Iwas 7 months pregnant. y Also a year ago I had acyst in my thyroid which was drained then filled upagain.

y I just object to having things wrong with me. Iexpect to be well. I am naturally energetic and fit anddon’t tolerate any illness. y I got so annoyed aboutthe injustice of the hospital system while I was havingmy hysterectomy.

y I am the middle child of 3. I have always taken myresponsibilities for my family and my work veryseriously y I have always wanted to do well y I amconscious that I have always inflicted very highstandards on myself which are above my abilities. yI am always trying to improve but it feels as if I amchasing something that doesn’t exist y I feel that Ihave a poor natural ability to concentrate or

rofessional version 6.1, expert analysis settings using Complete

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assimilate, but the more my memory flags the more Iwork with enthusiasm y My self confidence is lowy I keep trying hard to prove myself capable y Myhusband is my rock, he is so kind.

y I have loved horse riding since I was 11 y I wasbullied into buying the wrong horse by a friend y Ijust took the anger inside and let it fester y Now Ihave a new gentle horse and ride with more gentlepeople.

y A year before the hysterectomy I was in a head-oncar crash y I was so self-critical after that y I wasalways telling myself that I was responsible, that itwas my fault y I only cried a little, I expected myselfto just get over it. I could never have a really goodcry.

y My father died 7 years ago (begins to cry) y Icried so much after he died, but this is the first timethat I have cried about him for a while.

y I am involved in a refuge for abused women and Ilook after an abandoned gypsy horse. I feel peacefulwith horses.

y I get photophobia in the sun and feel uncomfor-table in general. I used to sunbathe a lot y I feelenergized and excited during thunderstorms. When Iwas young I was afraid of thunderstorms y I feelrefreshed and my energy goes up if I have a little sleepin the afternoon y I get wide awake with white wineand can’t sleep, but red wine makes me very sleepyyI absolutely hate butter and orange peel y I likegassy drinks and Italian food: tomato, garlic, cheese;and salt. y I feel better alone when I am ill andworse from consolation.’’

Analysis

She had a huge fibroid uterus leading to ahysterectomy and a cyst in thyroid—this combinationof symptoms is similar to Case 1. She is a gentleintrospective lady who tends to suppress her an-ger—this is similar to Staphisagria. Recent experiencein treating Case 1 led to a prescription of Aurummuriaticum natronatum without formal repertorisation(ie using the recognition, then representative, thenavailability heuristics1—all open to bias—yet effectivein this instance).

Homeopathic treatment

Aurum muriaticum natronatum: 200 cH 1 dose (onepill) and 30 cH drops as required (30ml stock bottle).

Outcome

Amelioration of presenting complaints (persistenttiredness, sadness, insomnia and loss of self-confidencesince hysterectomy) began from the first day oftreatment. The thyroid cyst resolved in 24 days andshe rapidly progressed to complete recovery.

Comments

The patient lived 300 miles away and attended foronly one follow-up appointment. Further communica-tion was by written note in a Christmas card from thepatient: she took Aurum muriaticum natronatum 30 cHdrops as she felt she needed to every 2–3 monthsresponded quickly and remained well emotionally andphysically with normal energy.

Case 3:Severe depressionandeczemaSummary

‘‘M’’ is now 50 and I have treated her withhomeopathic medicines for 11 years. She presented in1996 with eczema, anxiety over the poor health of herchildren and sadness due to marital disharmony. Sheresponded to some extent to Carcinosinum (Burnett),Ignatia amara, Natrum carbonicum and Magnesiamuriatica. In 2002 she developed severe endogenousdepression with persistent suicidal ideation. Treatmentby a consultant psychiatrist with nine different anti-depressants at full doses plus a course of nine electro-convulsive treatments did not ameliorate her depres-sion. Her depression responded slightly to Aurummetallicum, better to Aurum muriaticum and well toAurum muriaticum natronatum. After 2 years oftreatment with Aurum muriaticum natronatum pre-scribed in ascending LM potencies daily she was ableto stop her psychotropic drugs.

Appearance and manner

She has a long oval face, a natural dignity and grace,black curly hair and green eyes. She smiles to hide hersuffering, has a cheerful manner and laughs inappro-priately to hide her true feelings.

March 1996–November 1999

‘‘I have dermatitis on my neck y I am a districtnurse caring for patients with cancer y I took all theresponsibility for caring for my husband’s fatherwhile he was dying of cancer. I carried a lot onmyself.

y I am not very good at enjoying myselfy I need toknow that everyone else is OK before I enjoy myselfy I take on all the responsibility and take theresponsibility off other’s shoulders y I want every-thing tidy and sorted out y I resent it when otherpeople are enjoying themselves y I feel guilty when Itry to relax and try to enjoy myself y even onholiday I have to organize everything so that they areall happy y I defuse situations to avoid argumentsand confrontations y I don’t like to upset others. Iwant to please everyone.

y I prefer working in the community and workingby myself y because then I can maintain my ownstandards of work and care y I have very high

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standards and do my best to protect the dignity of mypatients.

y I remember criticism vividly y I could never dowell enough for my father y I dislike being watchedy I need space to be y to be alone y It takes me along time to recover from emotional injuries y Ihave to do my duty in order to be able to enjoy myselfy I have to earn enjoymenty I always put everyoneelse first.

y I feel as if my daughter is trying to hurt me y Iwant my daughter to be well so that I can be happyy I cannot let go of my responsibilities and myfeelings y I keep feeling I should not be enjoyingthings y I am wary of saying I am enjoying anythingbecause I fear that it will go wrong, that somethingbad will happen y I feel that I don’t deserve to behappy.

y My father had such power over me y nothing Idid was good enough y He never acknowledged thatI had a learning difficulty y I do not want to see myfather or speak to him.

y My mother died of dementia in September. (tearsin eyes and pink face but will not let herself cry, thensmiles to hide the pain) y I belittled the hugeamount I did for my mother, and all the work ofnursing her and arranging everything for the funeral,to decrease the guilt of the rest of the family y theydid nothing, yet I wanted to protect them from theirfeelings of guilt y I feel so unappreciated y I feel asif I am responsible for protecting my brothers andsisters from my father.

y I feel as if I am looking after everybody and noone is looking after me y I feel hard done to and notcared for.

y Father told me I was wrong, always wrong. y Iwas an embarrassment to my father y I am afraid ofhim and I always think before I speak so as to notupset him. I was taught by my father not to show it ifI was hurt and to consider the consequences of what Ido or say so as to not upset him. As a mother I havealways tried to be careful what I say to my children sothat I don’t hurt them.

y I dwell on it all so much y I am torn betweenfeelings of wanting to look after everyone, and feelingwhy should I y yet I am still trying to anticipateeveryone’s needs. y I care too much what othersthink of me.’’ (laughter, with tears in her eyes.)

November 1999–December 2001

‘‘I feel as if I am sinking y not in control y I have atremendous need to help people, for them to behappy y to appreciate me ‘y to think well of me yI need to help people and I can’t y I have a metallictaste in my mouth.

y There is a deadness inside me y I take hurts veryeasily to heart.

y I feel a peculiar sensation in my abdomen, almostlike a pregnancy, like a limb moving, or like a limb

thy

pushing its way out of my abdomen—on and off forabout 2 hours each time.

y I had a dream—I felt as if I have done somethingwrong and I am going to be found out. I woke upwide awake with fear and could not get back to sleep.

y As a child, I was never shown whole-heartedunconditional love, especially not from my father,but not even from my mother. y I want so much tonot hurt or upset my children y It is as if I need toanticipate what they want before they even know theywant it—yet I resent it and feel torn and guiltybecause no one does that for me.’’ (She is depressedbut hides how she is feeling and how severely she isdepressed behind a beautiful poignant smile.)

Consultation August 2002

(A big smile, yet fighting off the tears) ‘‘I am in aterrible state. I just fell apart and was admitted tohospital. I have had no response to maximum doseProzac and now am on maximum dose Venlafaxiney I realize that I have been denying that I have beendepressed for years, and then I was fighting beingdepressed for years. I kept on telling myself I am toostrong to be depressed y I have been havingcounselling and psychotherapy and see the psychia-trist once a month.

y I feel hopeless. I can’t fight it any more—all thefighting was futile—it does not help. y I cannot evenimagine ever going back to work again y

y I have no worth except within my family—unless Iam doing things for my family y I cannot let anyonehelp me y whatever I do is wrong y I feel so guiltyy I am worthless y I have no value in my self.

y I long to die y I know my family could managewithout me y I am so tired y I am barelysurviving.’’

Diagnosis: Suicidal depression.

Analysis 2002

In this case the initial physical expression waseczema after prolonged anxiety about her children’shealth. There was a profound disappointment from theincreasing failure of her marriage. The underlyingsadness gradually became a severe depression. Theemotional symptoms of sensation of having neglectedher duty and lack of self-worth are present from theonset but deepen with time. There are markedsymptoms of anxiety of conscience, remorse, self-reproach, despair, desire for death and suicidalthoughts leading to Aurum metallicum (see Graph 3).

Rubrics:

�

Mind; ANXIETY; Conscience, of � Mind; REPROACHES; Himself*** � Mind; DELUSIONS, imaginations; Neglected; duty,

his**

� Mind; DESPAIR* � Mind; SADNESS***

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Graph 3 Repertorisation of Case 3, August 2002. (MacRepertory Professional version 6.1, expert analysis settings using Complete

Millennium Repertory of Van Zandvoort).

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�

Mind; SADNESS; Suicidal disposition, with* � Mind; SUICIDAL disposition* � Mind; SUICIDAL disposition; Thoughts* � Mind; DEATH; Desires*** � Mind; CONFIDENCE; Want of self* � Mind; REMORSE; General** � Mind; DELUSIONS, imaginations; Worthless, he

is***

� Skin; ERUPTIONS; Eczema*.

August 2002–August 2003

Aurum metallicum LM1 30ml 2 drops daily in waterbegun from August 2002. From August 2002 toAugust 2003 treated with Aurum metallicum risingfrom LM1 to LM6 drops daily. There was a gradualdefinite amelioration which reached a plateau andincreasing the potency of Aurum metallicum did nothelp. The psychiatrist kept changing her antidepres-sants which hampered clear assessment of progress butoverall there was a sustained improvement which thenreached a plateau.

Examples of shift in symptoms

1.

I respond as I think I ought to—I long to die. Shifts

to I am still longing to die, but not all the time. Shifts

to I still sometimes feel that dying would be a release,but I am not longing to die all the time.

2.

I know that I am not fit to go back to nursing, but if Ilose my job I lose my identity. Shifts to I ambeginning to wonder if I might do somethingdifferent—it is a beginning.

3.

Initially wore loose fitting clothes of neuter gendershifts by May 2003 when she begins to wear feminineclothes—silk blouse and long silver earrings.

August 2003–June 2004

I prescribed Aurum muriaticum LM6 in August 2003,and there was a clear response which then reached aplateau. Her psychiatrist has not changed her anti-depressants since Aurum muriaticum. She was sepa-rated from her husband, and bought a house funded50% from the diocese (at the insistence of the bishop)and with help from her siblings. In April 2004 herfather died—I prescribed Ignatia amara 200 cH dropstwice a week.Permission was obtained to get further opinion from

colleagues Drs Julie Geraghty and Anton Van Rhijn.Six months treatment with Falco peregrinus dominatus30 cH and then 200 cH produced no further improve-ment. Case discussed/notes sent to Drs MaurizioItaliano and Flavio Tonelli.

May 2005

The initial partial responses to Carcinosinum andIgnatia amara suggest the miasm might be cancer(Aur-m-n miasmatic spectrum appears to be fromsycosis to syphilis). The disappointed romantic loveand sustained anxiety are similar to Case 1. Thesustained amelioration from treatment with Aurummetallicum and then Aurum muriaticum, clinicalexperience of treating Cases 1 and 2 and discussionwith other homeopathic physicians suggested anotherAurum salt. Aurum muriaticum natronatum featuresstrongly using the Complete 2005 Repertory with thesame rubrics used in 2002 (see Graph 4).

Homeopathic treatment May 2005

Carcinosinum Co: 200 cH 1 dose and repeat monthlyfor 6 months, begin Aurum muriaticum natronatumLM6 30ml 2 drops daily (beginning 2 weeks after the

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Graph 4 Repertorisation of Case 3, May 2005. (MacRepertory Professional version 6.36, expert analysis settings using Complete 2005

Repertory of Van Zandvoort).

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first dose of Carcinosinum Co) and increase potency toLM 8, LM 10, etc. each bottle used up.

Consultation August 2005

‘‘yI went to Canada for a holiday. There were 5 ofus sisters and nieces. I wouldn’t have minded if theplane crashed and I died, but the holiday was lovely.y I have been OK. My sister is very ill with breastcancer and I have been looking after her in Spain andwill soon go back. I have been having cognitivetherapy from another psychiatrist and it is good. Iseem to be able to put things in perspective better. yI am still tired and reluctant to get out of bed. yBeing with my sister and caring for her as a sister anda nurse (as much as she will let me—we are verysimilar) is good for both of us. I am going to spend alot of time in Spain with her. y When I take thedrops I actually feel some effects for the first timeever.’’ (Observation: ‘‘Mona Lisa’’ smiles still. Hereyes are greener. She looks more feminine and has alovely tan. There is some eczema on her neck for thefirst time since 2002 and the onset of the suicidaldepression.)

Consultation May 2006

(Observation: she has a tan, her eyes are green andshe looks more feminine in a pretty blouse andflowing skirt and sits like a lady.)

‘‘y I am spending more time in Spain than herelooking after my sister. I still feel responsible forpeople and always put others first. I feel it is notpossible yet to give to others without its being takenfrom me—it just drains me.’’

thy

(Observation: tears begin to run from her eyes andshe does not say sorry. For the first time she just takestime to cry and is then better.)

May–November 2006

After some 3-month gap in menses and hot flushesand night sweats which increased for 9 months Iprescribed Sepia officinalis 12 cH 1 pill b.d. She did nottake the Sepia as she felt that the consultation wouldbe enough and the flushes settled spontaneously. Shecontinued Aurum muriaticum natronatum LM12, thenLM14 and then LM16 and continued Amitriptylline150mg and Lamotrigine 100mg.In October 2006 her energy went down to ‘‘almost

zero’’ and she felt very groggy and sedated during theday. I changed the potency of Aur-m-n to 200 cH 2drops daily but this had no effect after 6 weeks.

Consultation November 2006

When do you feel OK (or even a bit better) and whatis the context?

�

When nobody wants anything of me. � When I am alone—especially when I am alone at

home and no one is there.

� When I am alone in bed—I would just love to stay in

bed all the time.

� When I am in bed dozing on and off—I could do that

all day.

� When I am resting—exercise feels like something I

ought to do and it does not make me feel better.

Why?

�

When I am with people I feel judged. � When I am with people I feel their expectations of me.

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�

When I am with people I feel I say the wrong thingsand that people will be cross/angry with me. � My father taught me, forced me, to think before

saying anything to think what effect it would have onhim.

� When I say something to upset people I feel that it

undoes any good that I have ever done before.

Comment

The context of amelioration and the reasons are stillmost consistent with the inner state of Aur-m-n. Yetshe has very little energy and is sedated throughout theday. It is possible that her depression has lifted andthat she is feeling the primary action of Aur-m-n plusthe sedative effects of the psychotropic drugs. Afterprolonged discussion with the patient and Drs DavidLilley and Maurizio Italiano I advised her to stop theAur-m-n for a month and to decrease and stop herpsychotropic medication under the supervision of herconsultant psychiatrist. She stopped the Aur-m-n for 4weeks and her inner state remained the same but shefelt so heavily sedated. She then approached herpsychiatrist who was delighted to supervise thecessation of her psychotropic drugs. I advised her totake Aur-m-n 200 cH daily for 5 days when beginningthe drug reduction (10 drops from 200 cH stock bottleinto 500ml of mineral water in a 750ml glass bottle,succuss 100 times before each dose, take a mouthful ofthis daily for 5 days). This posology was commendedby Dr Italiano as the context of amelioration, and thereasons are still most consistent with the inner state ofAur-m-n and to facilitate the reduction of psychotropicdrugs.

Consultation 26 April 2007

‘‘I took the last dose of Amitriptylline on 1st Marchand the last dose of Lamotrigine yesterday and I amfeeling so much better. I have felt much morepositive, less weary and have had much more energysince I stopped the Amitriptylline and my concentra-tion and memory have improved since I reduced theLamotrigine. I am very pleased and I am lookingforward to taking nothing. I want to be OK.

y I don’t feel drugged now, so I am not sleeping likea dead thing. I wake up through the night, sometimesafter dreaming, or to go to the toilet or with a hotflush and it is OK. I listen to music for a while and goback to sleep. There are actually days when I feel likeI used to feel many years ago. It is hard for me to justbe, instead of adopting a role of nurse ormother—the caring responsible one—but I ambeginning. y I have filed for divorce—it has beenlong enough just separated, it is over—and I feelgood about that. y I realize that I need to live alonefor a time and just live today. I have things in betterperspective somehow y The guilty it’s all my faultand its all out of control feelings are still there but I

am now able to recognize and realize that I can allowthe feeling to be and just step back from it.

y It was my 50th birthday the day I took my secondlast Amitriptylline dose. My daughters and my sisterfrom Spain arranged a surprise party in a spa hoteland all four of us had a lovely girlie weekendtogether.

y Yes, the eczema is back and it is itchy but I justscratch it and the patches come and go by themselves.y I got a chest infection while I was in Spain recentlywith my sister and I just took antibiotics like anormal person would and I was OK. y I smokewhile I am in Spain because I enjoy it and my sistersmokes but I don’t smoke when I am in Britain.’’

Observation: She is wearing a flowery silk blouse,well-cut trousers and long dangly earrings and has hadher hair dyed and styled. She maintains open andprolonged eye contact without looking away or puttingup her internal shutters. She is very ‘present’ in theconsultation. She smiles in a genuine way and did notsay sorry even once during the consultation. She lookshappier and better than she did in her first consultation11 years ago.

Comment

Her inner state remained consistent with Aur-m-nfrom the first consultation even though it took me along time to recognize it. Two years of treatment withAur-m-n (plus psychotropic drugs) were required to lifther depression which had resisted psychotropic drugsand ECT. She has not only managed to stop thepsychotropic drugs without relapsing, but has maderemarkable progress in understanding and acceptingher internal state, and she has begun to find ways tolive. She will require continued careful observation.

Case 4:Eczemaand depression‘‘A’’ is a man, now aged 46, I treated him for a year

from 1996 and again since May 2005. He has blackhair and blue eyes.

Consultation October 1996

‘‘I am a reporter, now freelance. y I have had aneruption on my face around my nose and chin for ayear. (Observation: eczematous eruption). y I amconscious of it in my work. I feel it is disfiguring. Itfeels raw. y I have been tired all the time since I hadflu a year ago. I was unbalanced and giddy andaching all over and had stabbing pains in my ears anda sore throat. I couldn’t swallow solids and wantedcold drinks in sips. I had 2 lots of antibiotics and thenthe eruption came out. y I also have had a patch ofeczema on my right foot and on my scalp at thehairline for years.y I was chief reporter for a newspaper 6 years ago.My deputy had an affair with my wife. Our son was 2

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when it started. We had to work in the same office for3 years and I couldn’t stand the guy and had anervous breakdown. I was just consumed by anguish.y I have a new partner now.y I am intelligent but seem to be ruled by myemotions. I feel tremendous anger. I behave in acivilised manner but I feel I have been used and feelthat I have been treated like shit on someone’s shoeand all because I was afraid of losing my son.y I am a twin. My twin brother is mentallyhandicapped. He has a mental age of 2 and liveswith my parents. y I am aware that I feel guiltybecause I am OK. It has been very hard to leave him,but after my son was born something seemed to shiftinside me and I felt whole again.y I usually get a sore throat every year in Januaryand get a bit depressed. I hate being enclosed and ambetter since I started going to Tenerife for a holidayand playing tennis in January.y I had a left varicocoele when I was 17 and havehad 2 operations and then got recurrent epididymo-orchitis afterwards and have had a lot of antibioticsfor that.y My other brother committed suicide in 1992—hethrew himself under a truck. y I felt betrayed,abandoned and out of control. I burst into tears andcried for a whole hour with a friend and then went tobed and cried for days. y There is a lot of cancer onmy father’s side: 2 of his brothers and his sister.y I am better in a cool room and feel too hot over 21degrees. I prefer a coal fire in a cold house and amworse from hot stuffy air and much better outside inthe open air and always drive with the windows open.y I have had Hay Fever for 2 years worse in Apriland May when the trees flower. y I love thunder-storms—I get excited and energized and go outside tofeel the drama and spectacle. y My energy seems toseep away if I sit in the sun but I am OK playingtennis. y I am a night person—my energy shoots upin the evening and night after a slump from 3–6 p.m.and I have more energy at the sea. y I feel wobbly ifI don’t eat regularly and tend to snack. I love fish andspicy things with rice and vegetables.y I think I am too sympathetic to others—I feel putupon by friends because I can’t say no to them. y Iam absolutely terrified of heights especially cliffs,because I want to throw myself off to stop the terriblefear of falling. I am also scared of spiders. y I getanxiety before public speaking and for 24 hoursbefore I feel churning inside and can’t eat or speak.y I am easy to hurt emotionally and I will dwell on itfor ages and hold grudges. y I am very sensitive toreprimands and I feel rage if I am unjustly accused ofsomething.y I was always defending and sticking upfor my twin Ian and was very sensitive to others’cruelty towards him. y I weep like a girl at soppyfilms and feel better afterwards and I am easilymoved to tears by other people’s pain. y My writtenwork has to be perfect.’’

Summary 1996–1997

Carcinosinum (Burnett) 200 cH 1 dose, then 1MK 1dose the next day.All his symptoms cleared. The skin flared a little and

then healed completely. His anticipatory anxietyresolved and he even did a live radio show. His energybecame normal. The improvement lasted a year andthen began to fade but he again responded very quicklyto Carcinosinum (Burnett) 200 cH 1 dose then 1MK 1dose the next day then 10MK the third day and wasgiven a bottle of 10MK drops to use occasionallywhen required.

Consultation May 2005

‘‘The eczema on my face has returned in the last 3months and the drops don’t help. y I have changedjobs and am a self-employed public relations con-sultant with some very demanding clients.

y My parents are both in their 80 s and arestruggling to look after my twin brother Ian. Myfather is being investigated and might have prostatecancer. My mother has had cancer treatment and ahip replacement. The time is coming when I will haveto make provision to look after Ian. y I grew upalways protecting Ian. My fists did the talking if hewas insulted or bullied, but the thought of having tolook after him full time is too much. y I havebecome down and depressed again. It is hard to getup in the morning and hard to motivate myself.

y Last year I had some indigestion and they foundHeliobacter pylori on endoscopy and I had 2 lots ofantibiotics. Then I had a bad ear infection which didnot respond to another 2 lots of antibiotics so I wasput on erythromycin which gave me diarrhoea for 2months. I couldn’t eat and lost 2 stone—I was like askeleton.

y I am homosexual. I split up with my boyfriendafter nearly 10 years and have felt very isolated anddown for a year. y I wrapped my heart up in steelafter he left me because I couldn’t love like that andlose again. y I have been having casual sex andusing sex as a weapon since, but my heart isn’t in it.y I went on holiday to USA and was hit by athunderbolt love—my heart just thawed and thebarriers went, but it was just a holiday romance andhad to end. y I feel that if I start crying then I willnever stop. y It has all taken its toll. I am fed uptaking on other’s problems. I want to be myself and Ithink I deserve that. I want to live and be at peacewith myself and be free of the suicidal thoughts.’’

Analysis

The initial excellent response to Carcinosinumsuggests that he requires a medicine of the cancermiasm. There are similarities to Staphisagria in hissuppression of anger, rage, disappointed love,wounded honour. The profound depression withsuicidal thoughts, experience treating Cases 1–3, recent

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Graph 5 Repertorisation of Case 4, May 2005, using 1996 symptoms. (MacRepertory Professional version 6.36, expert analysis settings

using Complete 2005 Repertory of Van Zandvoort).

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advances in repertory structure and content in VanZanvoort’s Complete 2005 Repertory led to Aurummuriaticum natronatum even when only using rubricsappropriate to the first consultation (see Graph 5). Themultiple courses of antibiotics and severe reaction toerythromycin might imply a shift in his bowel florawhich may act as an obstacle to healing and indicates abowel nosode.

Rubrics:

�

Mind; LOVE disappointment, unhappy, agg. (33)*** � Mind; LOVE disappointment, unhappy, agg.; Grief,

with silent (5)**

� Mind; FORSAKEN feeling (172)** � Mind; DELUSIONS, imaginations; Neglected; he is,

she is (24)**

� Mind; REMORSE; General (92)*** � Mind; GRIEF (132)** � Generalities; AIR; Open; amel. (415)* � Mind; THUNDERSTORM; Amel. (8)* � Mind; DWELLS on; Events, past disagreeable (89)** � Generalities; AIR; Seashore air; amel. (40)* � Mind; SYMPATHETIC, compassionate (95)** � Mind; FEAR; High places (31)*** � Mind; FEAR; Animals, of; spiders, of (21)** � Mind; SENSITIVE, oversensitive; General; repri-

mands, criticism, reproaches, to (42)**

� Mind; RAGE, fury (188)* � Mind; FASTIDIOUS (75)* � Skin; ERUPTIONS; Eczema (331)*.

Homeopathic treatment

Polybowel nosode 30 cH 3 doses 12 h apart, wait 2weeks and then begin Aurum muriaticum natronatumLM4 drops daily.

Consultation June 2005

‘‘I feel easier and better inside. There was no effectfrom the pills but the change began with the first doseof drops. I still have some rash on the left side of mynose but the rest has gone. I feel more in control andnot so emotional. I am more relaxed. I have let go ofthe things that I have not control over and feel that Ihave the situation with my parents in betterperspective. y I have energy for the things I wantto do. y I am accepting how I am and am notbeating myself up about it. y I had 2 close friendsdie of cancer 4 years ago and somehow I am allowingmyself to grieve about them properly now.’’

He has a 90% improvement on a visual analoguescale.

Homeopathic treatment and outcome

Continue Aurum muriaticum natronatum LM4 2drops daily until well. He telephoned 6 weeks later toreport that his depression was completely cleared.

Comments

Polybowel nosode was chosen because it is not yetclear which of the standard bowel nosodes are relatedto Aur-m-n. A 90% improvement on a visual analoguescale at 6 weeks reveals the gentle power of the Q/LM 4potency.

MateriamedicaofAurummuriaticum natronatumA salt of gold, sodium and chlorine, chemical

formula AuCl3NaCl(2H2O), introduced by Hale and

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Burnett in treatment of scirrhous carcinoma ofuterus and breast. The symptom picture embracesthe themes and polarities of Aurum metallicumwith depression and suicidal ideation plus the Natrumand Muriaticum themes delineated by Scholten2 andothers. The Natrum themes—sensitive, vulnerable,alone and lonely, impulsive, withdrawn and closed,holding on, silent, grief and depression—are strong. Itcontains four chloride ions per molecule. The Mur-iaticum themes—mother/child relationship, care andnurturing, broken relationship, self-pity, attentionseeking, sadness, alone and antisocial—are verystrong.

Mind

There are ailments from

�

thy

Being forsaken, neglected and rejected

� Reprimands, insults, humiliation and scorn � Deceived friendship and wounded honour � Grief, especially death of mother or spouse � Disappointment and especially disappointed roman-

tic love

� Anger which is suppressed with silent grief � Unusual responsibility as a child.

The sensations as if can become delusions

�

Forsaken and abandoned � Neglected, deserted and insulted � Lost the affection of friends � Has done wrong and is guilty � Everything that he does is wrong and cannot succeed � Has neglected his duty and is full of remorse � Is worthless and unfit for the world.

There is anxiety of conscience, for others, anticipat-ing an engagement, when a time is set, about future,about health. There are fears of being forsaken (again),opinion of others, something will happen, failure, tobegin a new venture, cancer, death and crowds.The development of pathology on the emotional

level follows a pattern. It begins with a feeling of beingdeeply wounded, forsaken and abandoned followed bysuppression of emotions of sadness, disappointment,grief and anger. These are often very good, well-behaved children who learn to earn love by achieving.They are given too much responsibility when tooyoung. They lose touch with their emotions except self-pity yet retain their sensitivity to new emotionalwounds. Sadness with silent grief then emerges. Theybecome so sad yet cannot weep, or rarely weep whenalone, or feel if they start to weep they will never beable to stop. Consolation by this stage causes greataggravation because it is too late. Grief fromdisappointed romantic love then forms that last strawand they develop physical or emotional pathology.They are impulsive and fall in love easily, often withsomeone inappropriate and stay despite everything.

They dwell on past hurts and humiliations andeventually come to hate those who have hurt themand feel violent anger with remorse. Next they loathetheir life and desire to die but continue to smileand laugh to hide the pain and sadness. Depressionwith suicidal thoughts and disposition emerges andpersists.

General symptoms

Trembling from strong emotions; food desires andaversions similar to Nat-m: sweets, chocolate, salt,farinaceous, milk and fish; aggravation or ameliorationfrom sea air and sea bathing.

Pathology

Cancer and stony-hard benign tumours of uterusand breast, fibromyoma of uterus, auto-immunediseases, chronic inflammation of joints, bones, ten-dons, glands, thyroid, liver, spleen and tonsils.

Associated remedies

Aurum metallicum, Natrum muriaticum, Aurummuriaticum, Ignatia amara, Carcinosinum (Burnett)and Staphisagria. Wulfsberg has highlighted another12 associated remedies.3

Prescribing heuristic forAurummuriaticum natronatum

� Like Aurum metallicum and Natrum muriaticum

combined

� Large, hard fibroids of uterus � Hard tumours of uterus or breast plus thyroid disease � Ailments from disappointed romantic love � Depression with desire for death and suicidal ideation � Symptoms/keynotes of several polychrests.

ConclusionAurum muriaticum natronatum appears to be an

important homeopathic medicine which is probablyunder-prescribed in clinical practice—the six asso-ciated remedies above often being given instead. Theauthor has attempted to show a journey in under-standing of the medicine through his struggle tocomprehend four patients living with deep andcomplex physical and emotional pathology—this isdistilled in the heuristic above but lives in the wordsand experience of the patients.

Acknowledgements

Thanks to Drs Julie Geraghty, Maurizio Italiano,David Lilley, Flavio Tonelli and Anton Van Rhijn fortheir help with homeopathic assessment and advice on

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clinical management of Case 3, and the patients whoconsented that their cases be discussed.

References

1 Souter K. Heuristics and bias in homeopathy. Homeopathy

95:237–244.

2 Scholten J. Homeopathy and the Elements. The Netherlands:

Drukkerij Haasbeek BV, Alphen aan den Rijn, 1996, pp 227,

391.

3 Wulfsberg T. Three Pieces of Gold. Oslo: HomeopatiBokhan-

delen 1998, pp 73–80.

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