A Matter of the Heart
Pain, palpitations, pressure, grief … & relief!
I first met Jane, a lovely retired woman in her early seventies, when she visited our student clinical rotation at Southwest Naturopathic Medical Center. She was complaining of heart palpitations and chest pain, which she’d been having for several months, as well as episodes of anxiety and depression. She had been previously diagnosed with mild hypertension (high blood pressure), left ventricular hypertrophy (enlargement of the heart), and a cardiac arrhythmia (abnormal heartbeat).
High blood pressure and anxiety
Jane had been prescribed an ACE inhibitor (a drug commonly used for hypertension or heart failure) by an osteopathic physician. Later, another naturopathic physician had prescribed two natural products in place of the ACE inhibitor–a magnesium supplement and an herbal/nutritional combination product that included the herbs hawthorne berry (Crataegus oxyacantha), which is used as a heart tonic, and Indian snakeroot (Rauwolfia serpentia), which lowers blood pressure. Though she felt a bit better than she did before these treatments, Jane continued to have episodes of chest discomfort, palpitations, and elevated blood pressure. We learned from Jane that she had experienced depression at various times throughout her life, but had refused treatment by a psychiatrist, saying, “That isn’t for me.”
As Jane spoke with the senior medical student taking her homeopathic case, we learned there were no real patterns to her palpitations or chest pain. The chest pain was felt on the left side just over her heart. She described it as a tightness as if her chest was being squeezed. Both of these sensations seemed to appear and disappear at random. One thing was certain–whenever she experienced either of these symptoms, she would become anxious. When the chest pain began initially, she feared that she might have a stroke. She was afraid of the many medical tests, as well as the thought of surgery. Though she no longer felt she would die from her condition, her anxiety would still become prominent when she experienced these cardiac symptoms.
An old grief rekindled
Perhaps the most intriguing bit of information we learned from Jane was that she believed the onset of her symptoms had caused her to begin grieving again for her late husband. He had died nine years earlier from a heart condition. She found herself looking at old photographs every day and said she could sense that he was around her. She began feeling guilty that she had not been more considerate of him when he was suffering from heart problems many years ago. She felt she was not as compassionate as she could have been, and she blamed herself for it. She said she thought that she had dealt with his death already but admitted that perhaps in the past she had just “pushed back” the emotions.
After studying Jane’s case, the students and I agreed that the most striking or characteristic symptoms were those related to her husband’s death. She was suffering from grief and had begun to dwell on the past. Furthermore, feeling guilty about the way she had treated him, she had become self-reproaching. These symptoms were most characteristic to us because they were the strongest symptoms in the case. As we like to say on our clinical rotation, these symptoms were “the main thing” when the case was examined in its totality. They were also symptoms that had arisen together with her heart symptoms, making them concomitant to her cardiac complaints. (Concomitant = existing or occurring concurrently; associated). These emotional symptoms and their relationship to Jane’s cardiac complaints served to create a complete (or well-qualified) symptom that would lead us to a secure and confident homeopathic prescription.
Sturdy, three-legged stools
This idea of complete, well-qualified symptoms deserves further commentary because it is an important concept that is often misunderstood or overlooked by beginning students of homeopathy. Hahnemann tells us in Aphorism 153 of the Organon that general and indefinite symptoms deserve little attention, unless–and this is the important part–they are more precisely qualified. What does he mean by precisely qualified? This important question was clearly and eloquently answered by two of Hahnemann’s greatest disciples, Constantine Hering and Maria Clemens von Boenninghausen. Hering’s approach describes the four characteristics that together make a complete and well-qualified symptom. These four characteristics are said to have been written on the blackboard at the famous Allentown Academy. They include 1) sensation; 2) localities or tissues; 3) conditions or modalities; 4) concomitants. Hering tells us that, just as three points of rest will mathematically support any object (think of a stool with at least three legs versus a stool with only one or two), at least three of these four characteristics elicited in a patient’s case will serve to make a cure very probable.
In Jane’s case, we now knew at least three of these characteristics. She experienced palpitations and squeezing pain (sensation); on the left side of her chest at her heart (location and tissues); and with these sensations she suffered ailments from grief, dwelling on past disagreeable occurrences, self-reproach, and guilt (concomitants). This scheme could be reworked with the anxiety and depression symptoms as the sensation and the cardiac symptoms as the concomitants. Either way, we had complete, well-qualified symptoms that should lead us to an accurate prescription. In further examining the case, we also knew that Jane had a strong desire for salt, was intolerant of the sun, and that she distinctly disliked sympathy (conditions or modalities). As she told us, “I don’t want people to pity me.”
A remedy that works
The totality of these characteristic symptoms clearly pointed to the remedy Natrum muriaticum, which we prescribed in the 6c potency to be taken twice daily until her follow-up appointment in 3 weeks. Natrum muriaticum is a well-known remedy for people ailing from unresolved grief who manifest that grief by dwelling on unpleasant or painful events in their past, often leading them to feelings of guilt and self-criticism. When they are feeling this way, they tend to want to be left alone and do not wish to be consoled or given sympathy. Among the strongest physical general symptoms for Natrum muriaticum are an aversion to the heat of the sun and sunlight, and a strong craving for salty foods. Equally important, Natrum muriaticum is capable of producing profound effects on the heart, including constricting chest pain and heart palpitations.
When Jane returned three weeks later, she felt much improved. She had experienced no chest discomfort or palpitations since our last visit. She also shared with us that she did not find herself dwelling on her late husband nor blaming herself for the way she had treated him. She was less anxious about her health and found herself craving salt and sweets less frequently. Her blood pressure was normal. We asked her to continue Natrum muriaticum 6c twice daily and return in 4 weeks.
Four weeks later Jane reported that she had recently begun to experience the chest pain again, accompanied by fear and anxiety. Her blood pressure was still normal. She had no other new symptoms. We decided that she was no longer reacting to Natrum muriaticum 6c, but that her case was still well covered by this same remedy. For this reason, we gave her a higher potency of Natrum muriaticum, instructing her to take the 30c potency twice daily.
When Jane returned four weeks later, all of her symptoms had improved. She had no chest pain or palpitations and was not dwelling on her past at all. Her blood pressure was normal. She has continued this way in the five months that have followed without any further changes to her remedy. In fact, her blood pressure has started to become a little too low, and we will be recommending to the other naturopathic physician managing her case that she discontinue the blood pressure-lowering supplement previously prescribed, as she no longer appears to need it. Jane continues to take the homeopathic remedy twice daily, and we currently speak with her for follow-up evaluations every eight weeks. At some point in the near future, if she continues to improve, we will have her discontinue the homeopathic remedy altogether and just continue to monitor her condition. This method of dosing the remedy daily was originally developed by the renowned Argentine homeopath, Francisco X. Eizayaga, MD, and is carried on by his three sons in Buenos Aires, Argentina.
Healing body and mind
This case is an excellent example of the power of homeopathic treatment to correct health problems of both a physical and psychological character. Jane improved as a whole person. The case also demonstrates what Hahnemann stated clearly and emphatically in Aphorism 153 of the Organon: the “characteristic signs and symptoms in the case are especially, almost exclusively, those to which close attention should be given…” Though Jane came to see us complaining of symptoms of cardiovascular disease and, for the most part, dismissed her depression as minor, the most characteristic symptoms in her case were those related to her unresolved grief over her husband’s death. Once the characteristic symptoms were recognized through careful and thorough case-taking, the selection of the homeopathic remedy was not difficult, and Jane’s health was restored rapidly and gently.