Over the top

Over-reactive, over-sensitive and always over-doing it, classic indications for Nux vom, writes Keith Souter

Few users of homeopathic medicine would doubt that Samuel Hahnemann was a genius. At a time when disease was ill-understood and the established system of medicine was at best dangerous, he developed a rational form of medicine that was gentle, logical and safe. His great book, The Organon of Medicine, written in aphorism form, falls into two sections, the first part theoretical and the second part practical. There is much in the book that doctors of any speciality would do well to include within their method of practice.

Aphorisms 84 to 104 advise about the best way of taking a case history. The essence of much of this is that the physician should allow the patient to describe his experiences, in his (or her) own language. This means noting down symptoms, subtle nuances and the patient’s literal utterances. Essentially, homeopathy is about the individual’s unique experience of their symptoms and condition, not merely the diagnostic labelling of illness or disease.

The student of homeopathy will also be aware that Hahnemann and his helpers “proved” remedies themselves. Aphorisms 105 to 145 outline how this must be done, and in Aphorism 109, Hahnemann states that he is the originator of this method of research. In these provings some of the remedies were found to have a broad spectrum of activity, and Hahnemann himself coined the term “polychrest” to describe them in his 1817 essay on Nux vomica.

So, with this in mind, let me now introduce you to Vanessa, whose case illustrates two features that Hahnemann identified in his early work. Firstly, what we can learn, often from a patient’s first literal utterances and our observations about them. And secondly, the multi-layered action of one of our oldest and most widely used polychrest remedies.

I’ve been told to see you!
Vanessa arrived early for our first consultation and she came well prepared. As I saw the preceding patient out I found her sitting in my waiting area, busily tapping away on her laptop. “Time is money, you can’t waste it,” she explained as I showed her into my consulting room, feeling a tad guilty as I had over-run with my last appointment. Tall, slim and immaculately dressed, she was every inch the businesswoman.

The mild rebuke had been delivered with a slight smile, yet her keenness to begin the consultation indicated to me that there was genuine impatience under the surface. And as she told me a little about herself – and it all tumbled out in a no-nonsense manner – it became clear that she literally meant what she said.

Vanessa is thirty­something, the financial director of a small manufacturing firm, “which is going to be really big,” she told me, matter-of-factly. She lives with her boyfriend John, a teacher in a middle school. They met at a local health club three years before and both enjoy an active sport life. And within moments she had told me about her competitiveness, her desire to win, whether at business, card games or tennis. “There’s no point in playing if you don’t want to win,” she explained. “I hate to lose!” And her facial expression emphasised that this also was true.

Marriage has been discussed in the past, but Vanessa is the one who has been reluctant to commit. She tells me that somehow she does not see herself settling down to housework, since she is used to working the hours she likes, earning the money she makes and feeling in control.

“Anyway, I’ve been told to come to see you! John says I have to get myself sorted out.” Again, no nonsense speech. “He can’t live with my PMS. He thinks I’m losing it sometimes. I just keep going over the top.”

Over the top
We talked about her temperament, which she admitted had always been fiery. But over the past year she had been aware of it being exaggerated for a week before each period. “My fuse just gets shorter and shorter,” she said. “And then I anticipate the period itself and that makes me angry, because I know it will hurt.” And indeed, her periods had become heavier, more painful, with sometimes debilitating spasms. “And the angrier I get, the more painful the periods are.”

And that was significant. She admitted to me that any symptom could get worse when she was angry.

“I just get so frustrated at times, then something snaps,” she said, describing how in the past she had broken a mobile telephone, thrown a cake that hadn’t come out right against the kitchen wall, and even once torn a new dress apart because of an annoying loose thread that “kept running instead of snapping!” All of these examples were at variance to her normal ability to deal with pressure.

Another significant feature: she could cope with the big things, but the trivial matters would be liable to make her blow her fuse.

At the emotional level she was aware that her fieriness extended to the big three emotions – love, hate and jealousy. She could love passionately, hate with a vengeance and of course, since jealousy is a mixture of love and hate, feel driven to extremes when jealous. When she felt these emotions, she expressed them forcefully.

At the physical level, she was also aware of overreacting. She felt pains intensely, they wore her out, and if troubled by constipation, which she frequently was, then it would cause her great pain and she would have to strain to pass a bowel motion.

“I don’t take well to criticism,” she volunteered. “When I’m in a mood I take everything to heart. John can’t understand that.”

And then she described how his untidiness offended her. “I’m meticulous about details in work and home. Everything has to have its place.”

At the physical level she had always been troubled with her “dodgy tummy”, which made her feel queasy for an hour or two after meals. These had to be kept small and she tended to react to a lot of rich foods, and also to excess coffee, which she admitted to craving and drinking lots of. She tended to experience spasm pains and invariably became bloated, which she disliked. “I barely eat if I’m on a business lunch because I know that my clothes will feel like a straight jacket.”

When she was a teenager she had suffered from asthma, but this had improved, except that she still felt wheezy if people wore too much perfume or aftershave near her. “I suppose I’m just over-sensitive to smells,” she said.

She told me about her headaches and the way that bright lights bothered her, as did loud music and changes in the weather. Indeed, she had once read an article about people reacting to weather changes, so she had bought herself a negative air ioniser, which had helped her headache tendency a lot.

She loves the heat and the sun, but hates the cold.

Always over-doing it
Vanessa admitted that she tends to over-do things. She is a self-proclaimed workaholic, party animal and a lover of the fast life. She drinks too much, smokes too much and has a taste for cannabis. “But I can get silly with all these things. I take too much, then I pay the penalty.”

Her pressure to do well would often eat into her social time and she would burn the midnight oil. “I work until the job is done, and if it isn’t finished I can’t sleep for worrying about it.”

Looking for the common thread
Homeopathic history taking is like producing a tapestry, an overall image of the individual’s own experience of their life and their problems. You then work backwards to tease out dominant threads, which go into the process of reportorising. But it is always worth stepping back just to see whether there are any recurring threads running through your tapestry.

In Vanessa’s case you can see that there are. They are – the tendency to over-react; to be over-sensitive to life, environment and relationships; and to generally over-do it.

There are lots of remedies in the materia medica that cover a lot of the features that Vanessa volunteered in her history, but only one that has them all. This is Nux vomica, the great polychrest remedy that Hahnemann wrote that early essay about.

Look for fieriness, fastidiousness, chilliness, over-reactivity, over-sensitivity, over-indulgence and you will have many of the indications for Nux vom one of the great healers. In days of old family chests contained Nux vom “temper powders”, and today almost everyone thinks of it as the “hangover remedy par excellence”. It has these qualities and much more. It can make life a lot more bearable when correctly applied.

The follow-up
To Vanessa the main problem was her PMS. With this in mind I prescribed Nux vom 30c, one powder to be taken twice a day for three days after her period had finished. This was to be taken over three successive cycles.

When she came for follow-up a few months later I was pleased to note that her PMS symptoms had improved greatly. Indeed, over the three cycles there had been a progressive improvement, so that when her third period arrived, she had not experienced any adverse symptoms. Indeed, she reported that, “John says it’s no longer like living on a knife edge.”

The period pains also disappeared after the first treatment, and to her delight the flow became more manageable.

Generally, she had felt better. Although still competitive and eager to do her best work, she felt more relaxed about things. And the fiery temper had not surfaced.

Her tendency to over­indulge had improved dramatically, to the point where she had stopped using cannabis, was about to beat the last cigarette or two a day, and she no longer drank (even at parties) to the point when she expected to have a hangover.

Six months after that Vanessa was enjoying life with John and feeling curiously released from the pressure that had forced her to go “over the top” with everything.

Nux vomica
Nux vomica is prepared from the seeds of the poison-nut, which contains several alkaloids, including strychnine. It is indicated if there is hypersensitivity, impatience, frustration over obstacles and when irritability is obvious to one and all. It is a great polychrest and much more than a bad temper and hangover remedy.

I leave you with Samuel Hahnemann’s own summing up: “Nux is chiefly successful with persons of an ardent character; of an irritable, impatient temperament, disposed to anger, spite or deception.”

Keith Souter MB ChB FRCGP MFHom MIPsiMed DipMedAc is a part-time GP in Yorkshire. He also has a private holistic medicine practise and is a newspaper columnist as well as the author of Homeopathy for the Third Age and Homeopathy: Heart & Soul.