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Irritable, tired and fanciful - a case of China officinalis
by Keith Souter
China officinalis was the first remedy to be proved by Dr Samuel Hahnemann. It is therefore a very important remedy in the history of homeopathy, and consequently it is one of the first that aspiring homeopaths study.
“As long ago as the year
1790 I made the first pure
trial with cinchona bark
With this first trial broke
upon me the dawn that
has since brightened into
the most brilliant day of
the medical art...”
The remedy comes from the Peruvian bark cinchona, which was used in the treatment of malaria in Hahnemann’s time. It was named in 1742 by the Swedish botanist, physician and zoologist Carolus Linnaeus after the Countess of Chinchon, the wife of a Spanish envoy who was reputed to have been cured of malaria in about 1640.
While translating a medical text by the Scottish physician William Cullen, Hahnemann found himself disagreeing with the author’s explanation as to how it worked. Cullen postulated that it worked because it produced a tonic effect on the stomach. Hahnemann thought this to be highly unlikely, because other astringents had no effect against malaria. Accordingly, he began dosing himself with the drug in his famous cinchona experiment. He found that he experienced symptoms not unlike those that occurred in cases of malaria. From this came the germ of an idea that was eventually to become homeopathy.
China is an extremely effective remedy. Indeed, in my experience, when it is well indicated, its results have usually been quite dramatic.
Jason was 12 years old when I first met him. He was not a happy young man. He had been well until that summer, when he suddenly became ill. He got up in the morning feeling quite well, and then as the morning went on he began to experience a headache. This worsened over the course of the day. He felt aching pains in all of his limbs and he started to pass very loose bowel motions. He also felt very tired and he became sleepy. His symptoms persisted over the course of a week, it being assumed by his parents that he had a form of “gastric flu”.
After one week of these symptoms he was taken to see his local GP, who arranged for some blood tests, including an IM screen to rule out glandular fever. These were all normal.
Over the next week he became much weaker, until he was unable to stand on his own. At the end of that week he was admitted to hospital with a provisional diagnosis of Guillain-Barré Syndrome. In hospital he had many tests, all of which were normal.
During this period of hospitalisation his bowels continued to be very loose, to the point that he had to have intravenous fluids to correct dehydration. Once that was corrected and the IV drip was taken down he began to experience pains in his back, knees, ankles and wrists. Further tests were done and a rheumatologist was consulted to exclude juvenile rheumatoid arthritis or other arthropathy. Again, all the tests were normal.
The pains settled down, but dizziness started.
The problems at discharge from hospital were that he had dizziness and weakness of his legs so that he had to use crutches and a wheelchair. He still had loose motions four or five times a day, but not every day.
His mood, which had been irritable from the start of the symptoms, became progressively more irritable and it was suggested by the paediatrician that his problems could be psychological. He reacted badly to being referred to a psychiatrist. He felt that all doctors were against him, that they did not believe him. He became irritable towards his parents because he thought that they too believed that his problems were all psychological.
As it happened, his psychiatrist was supportive and a diagnosis of Chronic Fatigue Syndrome was made in November of that year. He was by that stage unable to attend school, so his mother had given up work to tutor him at home. His strength improved slightly, but he was still using a wheelchair in the house. Outside the home he used crutches.
It was at this point that they decided to try homeopathy, since nothing else had worked.
Irritable, tired and fanciful
The first consultation did not start easily. Jason was openly hostile, suspicious and irritable. He was rude to his mother, angry that he had been brought to see yet another doctor and clearly felt annoyed that he was being made to go over his history yet again.
He did, however, gradually consent to answer questions. He admitted to being tired most of the time. He needed to sleep yet often woke up bathed in perspiration. In general, however, he felt chilly. He himself attributed it all to having lost so much fluid when he was first ill. His bowels were still variable, yet overall he thought that he had good days then an equal number of bad days. He experienced headaches in the same manner, with alternating good and bad days. Interestingly he felt dizzy when he had days with loose bowel motions.
His tiredness was the real problem. At times he could barely stand because his legs felt so heavy. And indeed, on examination, they did seem inordinately floppy with little strength. It was apparent during the examination that he did not like being touched.
In talking about how he was before he had been ill his mother stated that he had always been a bit of a dreamer. Jason then volunteered the fact that he had a rich fantasy life, often imagining himself as a comic book super-hero. Thinking that he was a super-hero helped him, he thought. I found this interesting, since many comic book heroes have alter egos with very definite flaws or weaknesses – some even have marked physical disabilities, which are the antithesis of their super-powered counterparts.
The history of the onset after the diarrhoeal illness was very clear-cut, as was the irritability, the hostility, the periodicity of his symptoms, aggravation from touch, the general chilliness and this very rich fantasy life. This all seemed to point to China officinalis, which I prescribed in a 30c potency twice a day for three days.
When Jason came back six weeks later he came in without crutches, although supported by his mother who carried his crutches for him. He was grinning and said that he felt very much better. I quote the written summary of notes made by his mother:
“Overall, Jason… is definitely improving and his energy levels are increasing. A marked improvement has been in the number of headaches he complains of and in the frequency of his tummy aches and bouts of diarrhoea. These still occur, but not as often... His mobility is steadily improving and he no longer uses the wheelchair in the house again. The psychiatrist... was very pleased with his progress when he saw him yesterday, whereas a month ago he was extremely concerned and was considering admitting Jason…”
A supportive remedy needed
Jason did well for three months, but then seemed to regress. He started using the wheelchair at home again. The skin worsened and the dizziness worsened. In addition, he felt exhausted at the slightest exertion, whether mental or physical. The loose motions, however, had seemed to settle and instead he complained of upper abdominal flatulence.
The China off. had to be reconsidered. Failure of the indicated remedy, especially with the cluster of symptoms that he was complaining of suggested that a bowel nosode could help to unblock this impasse.
The bowel nosodes are an extremely valuable group of remedies, which often have a place as intercurrent or supportive remedies. In Jason’s case I elected to use Bacillus No7, since it is indicated for flatulence, mental and physical exhaustion. A single dose in 30c potency was given.
This had an excellent result. Within two days he was picking up. The tiredness seemed to drift away and his strength returned day by day. The bowels again became loose one day and difficult the other. He reverted to the China off pattern, but it was much-improved.
Another supportive remedy
I continued to follow him up over the next year, his strength getting better and better. We carried on with the intermittent use of China off, with good effect. The wheelchair and the crutches were eventually jettisoned, but as he moved around more, he became conscious of pains in his calf muscles, as if he had been running and had “hit the wall”. This symptom I find often responds well to Sarcolactic acid and I prescribed this in low potency on alternate days.
Gradually he was able to extend his range of activity, being encouraged by his mother all the time. Since she was a golfer she managed to get him interested in learning the game, on a short local course, and over a period of months he eventually managed a regular nine holes. He continued to make steady progress.
Some keynotes of China
China is often kept in people’s medicine cabinets and is often thought of as a remedy for headaches, dizziness and abdominal bloating.
Its main keynote indications are periodic fevers and ailments that start after loss of body fluids. Tiredness, irritability and fancifulness are also usually somewhere in the background.
* Materia Medica Pura, Vol iii, 2nd Edition 1825
Keith Souter MB ChB FRCGP MFHom MIPsiMed DipMedAc is a part-time GP in Yorkshire. He also has a private holistic medicine practice and is a newspaper columnist as well as the author of Homeopathy for the Third Age and Homeopathy: Heart & Soul.