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Recurrent sinusitis was the presenting condition but, describes Marysia Kratimenos, underlying symptoms indicated a constitutional remedy of Thuja occidentalis
Susan was 23 when she first came to see me. Every cold led to a very nasty infection in her sinuses, with severe pain along the cheekbones, a green nasal discharge and high fever. She also had a cough every time she lay down, due to a postnasal drip and had noticed a small polyp in her left nostril. She was having repeated courses of antibiotics every winter, which upset her stomach and bowels. Her doctor was talking about sending her for a sinus washout, and the thought of this terrified her. This was the reason for her consultation, to try to avoid surgery. She was also very concerned about taking time off work for these infections, and tended to struggle into work when she was far from well, so as not to let the company down. She felt guilty every time she was forced to take a day’s sick leave.
The sinusitis recurred every autumn and winter, whenever the weather turned cold and damp. Susan began to dread the end of summer. The cold alone didn’t affect her as she was fine on skiing holidays. She was aware that humidity upset her, and would eagerly await storms to clear the air. She avoided saunas as she would always faint, but dry heat suited her. She loved hot sunny days. She wasn’t keen on strong winds, but was very clear that it was the combination of cold and damp that affected her most.
The recurrent bouts of sinusitis would make her depressed, although she was loath to admit it. Her moods did fluctuate considerably, and she could swing from a happy state into “the blues” quickly. The infections often brought this about and she blamed the antibiotics. On closer questioning she admitted her moods changed with her menstrual cycle and also the moon phases. She loved the full moon and found it energised her and lifted her mood. She was reluctant to talk much about the depression and I did not pursue the matter.
As a child she had been healthy, although always prone to colds and coughs. She would frequently have green nasal discharges, but not full-blown sinusitis until the age of about 18. After finishing her exams, she went with a group of friends back-packing around India before starting university. She had a fever and swollen arm immediately following the inoculations before departure. After a few days she returned to her GP, who prescribed antibiotics for an infection in the vaccination site. A few weeks later, the injection site broke open and green pus poured out. Eventually it settled down, but a scar remained on the left upper arm. It was quite unsightly and was frequently sore.
After the trip she started university, and in her first term was admitted to hospital with a kidney infection. She was treated with antibiotics in high doses through a drip. The x-rays did not show any damage to the kidneys, nor any abnormality in the urinary system. Unfortunately, she then became very prone to kidney infections, having attacks every couple of months, until she was put on prophylactic antibiotics for a whole year. It was shortly after this that the attacks of sinusitis began.
The frequent courses of antibiotics had led to constipation and bloating of the stomach. Susan noticed that certain foods upset her, in particular spicy food and onions. She ate a good healthy diet and craved chocolate before her periods. She was thirsty and loved drinking tea, having eight mugs or more a day.
She was prone to headaches, particularly in the left temple, which she described as stabbing in nature. The headaches came on before her periods or when she was over-tired. Overall her energy was good when she didn’t have an infection, but she was prone to feeling tired mid-afternoon. She usually slept well, and had pleasant dreams. Her father had died in his early 50’s of a heart attack, and heart disease ran in his family. Her mother and younger sister were in good health.
Susan described herself as a hard worker and “a bit of a perfectionist”. She detested taking time off work when she was ill and this upset her deeply. She regarded it as a sign of weakness. It was important to Susan to give her work 100 per cent, and she would stay very late at the office to ensure her work was done to her satisfaction. She was neatly dressed and beautifully made up. She was friendly and easy to talk to, but I detected a certain reserve especially where emotional matters were concerned.
Susan’s case clearly demonstrates the difficulty in prescribing Thuja on a constitutional level. It is the most frequently prescribed remedy for warts and “ailments after vaccination” and the constitutional picture is often missed. It is very common to see outbreaks of warts and verrucas in children starting school. It is often blamed on unclean swimming pools, but many of the children swam in the same pools before school without problems. The preschool vaccination often throws these children into a sycotic state and so they become susceptible to the wart virus. (Sycosis is a term used to describe a state where the body reacts to stimuli in an excessive way. The sycotic remedies are characterised by a sensitivity to cold and damp, green discharges and warts. There is frequently a family or personal history of early heart disease and high cholesterol levels, as well as diabetes.)
In Susan’s case history the onset of her health problems was shortly after the vaccines for her trip abroad. The first illness was a kidney infection, which is highly characteristic of the sycotic group of remedies, as were the following attacks of sinusitis with the green nasal discharge and post-nasal drip. The sensitivity to cold and damp is again characteristic of this remedy group.
It was the reservation and the depression that led me to the constitutional prescription of Thuja. George Vithoulkas describes the essence of Thuja as “ugliness”. This is applicable on the physical level with the warts, verrucas and the cysts that are prone to infection because of a greasy skin. It also is evident on a deeper emotional level. Although patients will not frequently admit it, at least before treatment, they often consider themselves ugly and unlovable. They cover this up by being perfect in their appearance, work, social life, everything. They fear criticism and this motivates them to create a situation whereby they are above reproach.
People sensitive to Thuja are prone to deep depression and can have suicidal thoughts, although this was not the case with Susan. The mood swings can be very rapid. In a depressed state there is great guilt and loss of self-confidence, which is shaky even in health. After treatment Susan told me that when she was “low” she felt hollow inside, as though her body was an empty shell. The books describe the “delusions” of Thuja as a sense of fragility and of feeling brittle, as though the person could shatter and break.
Immediately after the prescription of Thuja 30c, 30c and 200c over three days mid-cycle, Susan noticed a burst of energy. “No more wilting at 3pm - before I could almost set my watch by it!”
Next she noticed a sense of deep wellbeing. “I couldn’t stop smiling - everyone at work thought I’d fallen in love!” It was only then that she was able to tell me how she had felt so unattractive that “no one in their right minds could possibly want me”.
Over the next few weeks, she noticed a great reduction in her sensitivity to the cold and damp. Her cough went and the polyp in her nose slowly reduced in size. The scar on her arm also started to heal and she felt sufficiently confident to wear sleeveless tops and dresses again. Overall her confidence and self-esteem had improved and she worried far less about what others thought.
Before treatment, she was very concerned about this and would frequently go out of her way to please friends, co-workers and family. Thuja patients can often struggle with identity issues, in that they are so keen to maintain others’ happiness that they can sacrifice their own needs, wants and even their ego.
In the past year Susan has not required any further doses of Thuja. She has not had any attacks of sinusitis, thus avoiding the surgeon’s knife, much to her delight. She has stopped working so late and is enjoying a busy social life. Her energy remains high and the low moods have disappeared. A course of Acidophilus and a three month yeast and sugar-free diet sorted out the antibiotic induced bowel problems.
Susan’s story shows how deep acting a remedy Thuja can be. It was not readily apparent from the initial consultation how she felt about herself. She projected a friendly, cheerful image, which gave no indication of how poor her self image was. Thuja was a very reasonable prescription on a physical level, covering all her symptoms. On a constitutional level it had a very profound effect on her emotional well being.
Thuja occidentalis is an evergreen tree, native to North American and Canadian wetlands. It is known as the Tree of Life. The wood was burnt at sacrifices and the Egyptians are said to have used it for embalming. Long before Hahnemann introduced it to homeopathy, the North American natives had discovered its medicinal qualities.
The tree is beautiful, growing slowly to a height of some fifty feet. It has a fragrant aroma. The stems are covered in tiny nodules, that look like warts and they are concealed by the lush green of the leaves. It is almost as though the tree itself is trying to conceal its ugly side.
The homeopathic remedy is prepared from the fresh twigs and leaves. The tree contains an essential oil which is used for the treatment of wart infections.
As can be seen in Susan’s case history, it is a very deep acting remedy, particularly in higher potencies, and should therefore be treated with the respect it deserves. Bill Gray describes Thuja as the “Great Masquerader”. As a result of the fragile sense of identity, it can be easy to confuse the remedy with several others. The secrecy about the “shadow side” combined with the need to please, can make it difficult to see the full remedy picture. Often it is the physical symptoms that underlie the prescription.
Marysia Kratimenos trained in general surgery after qualifying as a doctor at Guys. She was introduced to homeopathy when her son was very ill and she saw at first hand how it worked for him and how it also eased her mother’s condition before she died of cancer. In 1995 Dr Kratimenos joined the the staff of the RLHH where she is involved in stress clinics, general medicine, pediatrics and neuro-linguistic programming.