“I’m afraid to go to sleep in case I die”: A case for Musk

Dr Raymond Sevar describes the case of a patient successfully treated with Moschus moschus

Musk is one of the oldest ingredi­ents in perfume and has been extensively traded since the 6th century. It is a secretion of the scent gland of the male Siberian musk deer, used to mark its territory and to attract females during the rutting season. Musk has a sweet, penetrating and very long lasting odour and is still used in expen­sive perfumes to give an “erotic lift.” Musk has been used for 5,000 years in traditional Chinese medicine and as an aphrodisiac. It has effects on the nervous and circulatory systems – in small doses it causes stimulation to the brain and makes the heart beat harder but not quicker.

The musk deer’s habitat is the forests and brush­land of Siberia, Mongolia, Korea and north eastern China. They have no antlers or tails but have long a harem of females. They do not migrate and are able to survive the long dark severe winter weather by living off stores of body fat.

Terrible state
The way I first prescribed this remedy is unusual. In 1994 a man came for homeo­pathic treatment of rheumatoid arthritis and angina but before he would tell me anything about himself it was “his boun­den duty to tell me about his wife who is in a terrible state. She is terrified to go to sleep because she is convinced that if she does she will die. She gets completely hysterical – just terrified – she is utterly convinced that she will die in her sleep. She sits up and drinks coffee and watches TV and of course eventually she does fall asleep and wakes up OK in the morning, but the next night she is terrified and com­pletely hysterical again.”

Practitioner response
How to respond? The patient has a very clear and strong expectation. It would take great skill to say no without producing a stand­off situation.The patient’s wife had already been seen by her GP who was satisfied that she did not have a psychiatric disorder nor merit referral to a psychiatrist. Her GP had prescribed sleeping tablets which had had no effect. This was the first and is the only time I ever prescribed a homeo­pathic medicine without a consultation. I only did so only after giving very clear instructions to the husband, written instructions for his wife on how to take the medicine, making full written clinical notes of her symptoms and the prescription, and insisted she attend for a full consultation when her husband came for his review. I prescribed Moschus moschus.

Two months later I saw her husband who told me: “She is great. My wife took the medicine and went to sleep OK the first night. She took it again two weeks later when the fear came back and she has been going to sleep easily.” She did not want or feel a need to come for a follow­up visit. Four years later she reappeared and she didn’t mention my prior prescription. Her problems were uncontrollable weeping, anxiety and tiredness. She was an overweight attractive 51 year old lady with grey hair, big soft brown eyes, flushed cheeks and greasy skin. Before I had a chance to ask her anything she just burst out crying and continued weeping for several minutes.

Hair being pulled
“I just keep bursting out crying all the time and its getting ridiculous – as soon as I start to speak I burst out crying – it happens with everyone … I don’t know why, there seems to be no rea­son …. I feel better for a while after I have cried …. If someone shows me sympathy I cry but I don’t like it … I just can’t cope with anything any more – I panic if I think there is not enough time to get something done and my thoughts keep whizzing round and round in my head and then I get dizzy and feel as if I will fall … I am eating chocolate, sweets and biscuits for comfort all the time and can’t stop

…. I feel as if my hair is being pulled
… I feel as if someone has got hold of my hair and was pulling it off my scalp

…. I don’t really feel well since I had a convulsion a year ago, my confidence has gone down … I have had epilepsy since 1969 and take Epanutin 50mg twice a day … I know it’s a small dose but any
more makes me feel awful …. The convulsions start with an odd fuzzy feel­ing in my head, then there is jerking of my hands and arms while I am conscious and then I pass out and my husband says then I jerk and spasm and after I wake up and I have been incontinent.

…. I feel OK walking on the flat but I get very puffy and short of breath on hills … I am chilly but I overheat easily … I am just tired, energy 40/100 …. I am very scared of thunderstorms I just hate them. I curl up in a ball and shudder with each flash of lightning … I get a sickly headache if I sit in the sun … I love the sea and feel better at the sea – I feel free …. I absolutely hate oysters, mussels, cockles. I forced myself to try an oyster once but I could never eat another …. I am really scared of spiders and heights and narrow closed in places – even seeing someone pot­holing on TV I start gasping for air.”

Analysis and treatment
If I had remembered prescribing her Moschus four years ago her subsequent treatment might have been simpler. Looking back at my case notes I am struck by the fact that I wrote down and put a big circle around “attractive with big soft brown eyes.” In 1998 I recog­nized a pattern of symptoms that fitted Calcarea carbonica – sensation as if hair pulled, anxiety, fears narrow, heights and thunderstorms, epilepsy, aversion oysters, overweight, comfort eating sweet carbohydrates – and prescribed 30C one dose, 200C one dose then 12C daily.

Resolution
The sensation as if her hair was being pulled resolved completely as did her weepiness, anxiety and comfort eating and she remained free of convulsions. In October 2001 she returned with new problems – osteoarthritis and panic attacks.

Panic attacks
“I have been good till the last six weeks – I have been getting stiffness in the fingers of my right hand – mainly the middle and little fingers and it feels tight and stiff in the palm … worse morning when I wake but it is there all day and when I stop using my hand it stiffens up more.”

On examination: her flexor tendons are thickened and tender and there is bony and joint swelling of the end joint of both index fingers

“I have been getting panic attacks again. My husband is leaving for the north of Scotland because he has got a better job and I don’t want to go. I get panicky and can’t settle and can’t get my breath and break out in a sweat … it comes on in the evenings and gets worse till about one in the morning. I am afraid that I will go crazy. I have had to stop work … I have had to come back. I could not stand the isolation of living up there in the north coast of Scotland – it was dead, desolate, and empty. There is nothing to see but the sea and nothing to do and nobody around …. My epilepsy is still OK, no convulsions … I have become exquisitely sensitive to certain perfumes and have to leave the room.”

This last symptom is very strange, rare and peculiar and typical of Moschus.

This time, treatment with Calcarea carbonica produced no improvement in six weeks and she relapsed to her original state.

Moschus like a miracle
A month later she came to see me and told me. “I am terrified to go to sleep in case I die in my sleep. It is just like it was years ago when you gave my husband Moschus for me to take. It was wonderful, like a miracle and I have had none of this trouble for seven years …. The fear is that I am terrified to suffocate and die while I sleep – it comes upon me just before I go to bed and while I am lying there, so I can’t go to sleep and then I get the feeling that I can’t breathe.”

*Gesture – her left hand goes to protect her throat/larynx with thumb on one side of larynx and fingers on the other – it is a fast but gentle protective gesture – and her right hand and arm make a ward­off gesture – and she looks at me with those big soft open brown eyes and I “see” the deer protecting her neck from a predator.

I prescribed again Moschus moschus.

Terror of a deer
At this point of recognition there is little need for repertorisation but I did consult my repertory for the following rubrics which all list Moschus: DEATH conviction of; DELUSION, death is approaching; FEAR of suffocation while lying down; FEAR to go sleep because of suffocation; HYSTERIA with sleeplessness; WEEPING hysteri­cal and involuntary; SENSITIVE to odors; STIFFNESS rheumatic in fingers & hands in morning; and CONVUL­SIONS. In his Materia Medica, Dr James Tyler Kent (1849­1916) gives a long and memorable description of the “hysterical nature of women” in a Moschus state. His description might nowadays be described as sexist and typical of a doctor of his age, gender and time, but it does clearly describe the hyper­vigilance and terror of a deer faced with a predator.

All change
Her fear and insomnia began to settle on the second day and resolved com­pletely in six weeks. The stiffness began to settle after four weeks, and there was less thickening of her tendons at six weeks. The tendon thickening and rheu­matic pain completely resolved and her osteo­arthritis of both index fingers stopped worsening and the joints became pain free. Her comfort eating stopped, she joined a gym, became the weight she wished to be and was able to move to the north of Scotland to live with her husband.

Dr Raymond Sevar BSc, MBCh DCH MRCGP FFHom is Dean of the Faculty of Homeopathy and a Homeopathic Physician in private practice in Carlisle, Cumbria. He also teaches homeopathy to doctors and other health professionals in the UK and abroad. Website www.raymondsevarhomeopathy.com