Arthritis, Keratosis, and Morton’s NeuromaDr. Robert Ullman, ND & Dr. Judyth Reichenberg-Ullman, ND, DHANP, LCSW May 4, 2015
A Case of Constitutional Calendula – Published in Townsend Letter
What is the natural topical preparation of choice in any homeopathic, and many a naturopathic, practice? Answer: Calendula cream, which we prefer to ointment preparations. We recommend it for cuts, scrapes, abrasions, lacerations, and to soothe the discomfort of eczema, burns, and many other non-fungal conditions. Not that it will do any harm with fungus – it just won’t help.
I, Judyth, was first sold on Calendula cream in 1981, during my second year of naturopathic training at Bastyr. I had the good fortune to work in a free medical clinic for destitute patients in Old Delhi, India. The neighbourhood, the Basti, was populated by Islamic families living in the most basic housing without running water or an adequate sewage system. Our program provided milk to the undernourished children and free basic medical care from a large tent with a dirt floor. We mostly dispensed soap and homeopathic medicines. I particularly remember an elderly man with a huge, angry gash on the front of his lower leg. We cleaned the wound each day, then applied Calendula cream and a fresh bandage. In a matter of a week, the skin had healed remarkably. Over the course of thirty years, we have seen many topical Calendula cures.
We are talking about the beautiful gold and yellow marigolds that provide the colourful centerpiece for flower and vegetable gardens as well as containers overflowing with eye-catching annuals. Calendula, along with Arnica (also yellow, but smaller and less showy), are members of the Compositae or aster family, known to treat injuries. The name, Calendula, derives from the opening of the blooms on the calends, the first day of the month. Marigold is associated by some authors with the Virgin Mary, and by others with Queen Mary of Stuart. The flowers are edible, freshly gracing salads or dried for use in soups. The old herbalists, like Culpeper, referred to the plant as “a comforter of the heart and spirit.”
Classical homeopaths who practice the Sensation Method of Rajan Sankaran recognize the need for these and other Compositaes when the patient’s chief focus is on hurt and pain. Words commonly used are hurt, pain, injury, excruciating, ache, and other words describing sensitivity to pain.
Calendula, along with Arnica, is particularly useful in acute injuries, especially excessively painful lacerations or cuts, and ragged, suppurating wounds. It has been used effectively for over two hundred years to prevent or thwart infections of open wounds, such as on the battlefield or during childbirth. It can be used, either internally, or as a dressing made from a weak solution of Calendula tincture and water, sometimes with the addition of Hypericum (St. John’s Wort). This plant is the best-known herbal wound dressing and antiseptic, tried and true. Calendula has also been used for superficial burns and scalds, inflamed ulcers with excessive secretion of pus, bed sores, and hemorrhages in scalp wounds or following dental extraction. It is also known to prevent scars and keloid tissue and to promote healthy granulation when applied topically.
We have recommended Calendula cream to most of our patients at one time or another. But, this is the first time in thirty-plus years of practice, that we have prescribed Calendula homeopathically. The results, you will see, were quite rewarding, for the patient and the prescriber.
Revisiting Homeopathy at the Age of 65
Helen, a community college instructor from Portland, had been helped by us for several years in her forties, likely benefiting from Calcarea carbonica (calcium carbonate; oyster shell). We are not sure because we had disposed of her long-outdated chart, but that is our recollection. She was one of those patients whom we had long forgotten about, but who had continued taking her remedy, with benefit, over the years. We were surprised and pleased to see her again two years ago.
“The remedy helped. Now I am having trouble with my memory. The other day I couldn’t remember that I had a ruptured appendix. Even as a little girl my memory wasn’t great. I have anxiety for no reason. My back acts out. I think I have arthritis in my big toes. I cough and sneeze and my voice becomes gravelly when I’m around dust. I don’t sleep well at night – I wake between 1:00 am and 4:00 am. I have a big lump in my foot from the Morton’s neuroma. I ache when I walk. Orthotics has helped somewhat and I received a cortisone injection. I had a number of breast biopsies in the past, but no lumps for a number of years. I don’t have any one big thing…. just a bunch of little ones.”
“It’s the tightness of my body. I have scoliosis in the top of my back. The muscles are tight. It feels like I’m just wires inside – instead of your muscles being how you can manipulate them. Like big, thick wires that don’t want to give… don’t want to bend, move. Maybe rods, rather than wires. I don’t move as easily. Like if you scrunch your fist up and you hold it like that. I have to be so careful about how I move. I’ve gone through a lot of chiropractic care. Tight… restricted movement. When I get up in the morning, I have to move slowly. More stiff than flowing. Like I’m carrying a big load… like the character with the bag on his back. All humped over. I think I’ve always felt tight. My movement has always been restricted.”
Since [an accurate diagnosis requires that] the sensation should permeate all of the patient’s case, we asked if Helen experienced tightness in any other area of her body. “My root canal. I had to keep my mouth open so long. I’ve always had a tight jaw. It just clenches down. Or when I’m on a plane. I can’t wait to get out. I like to sit on the aisle. Otherwise I feel hemmed in. When I drive it always feels good to get out of the car and walk… My neck gets really stiff on the right side, sometimes to the point of waking up with a migraine. And my right jaw keeps clicking and going out of joint.”
“As a child I had eczema inside my elbow. My dermatologist gave me a new topical medication for it, but it made me turn beet-red and I had to stay inside. I had eczema on my arms. Calamine lotion made it better.”
Helen feared being alone, suffering, someone coming into her house, illness, and especially dying from skin cancer. She mentioned her longtime love of nature and plants.
The emphasis on tightness, restriction, inability to move freely, and a desire to get up and move around frequently matched quite well the Anacardiacae (cashew) family. There were no indications of a need for a mineral or animal medicine, which seemed to confirm a plant prescription. We prescribed a common homeopathic medicine for joint and skin complaints: Rhus toxicodendron (poison ivy) 12C to take in a plussed form daily. We also recommended Vitamin D, essential fatty acids, CoQ10 (50 to 100 mg), and an excellent calcium/magnesium/boron supplement.
Response to Rhus Tox
Five weeks later, Helen reported that her memory was improving. (She had discovered black mould in her bathroom, which she was in the process of having removed.) The neuroma was less intense and painful. “My lower back seems to be staying in place better.” Helen had somewhat of a positive response, but not convincing to a homeopath. Ten weeks after starting the Rhus tox, she was still experiencing some improvement. The moderate improvement continued and we did not change the medicine, nor the potency. In retrospect, we would have raised the potency to 30C much earlier. Six and a half months into the course of treatment, Helen told us that her big toe joints were doing great, the low back pain was 75 to 80% better since starting the Rhus tox, and that the Morton’s neuroma was almost gone. Her migraines had decreased somewhat. The keratosis had not been significantly affected by the homeopathy, but topical Vitamin E was helping. At that point we did increase the potency to Rhus tox 30C daily.
It may sound like Helen was feeling a great deal better, but we were just not convinced that we had found the best medicine for her. When we had prescribed the first dose of Rhus tox, the sensations did point clearly to Anacardiaceae, specifically Rhus tox. But, despite some positive strides, we decided to do a retake of the case history. This is when we meet again with the patient for an hour or so to take the case from scratch. It is an excellent way to see whether the same symptoms and sensations are presented – and the same kingdom, family, and miasm are confirmed. In many cases, when the response to the medicine has been lackluster, we are treated to a surprise. That was the case with Helen.
Retake: New Family and Prescription
This was now ten months after Helen had come back to see us. She was not unhappy with her response to the homeopathy, but we felt unsettled about it. We expect excellent, not mediocre, results from a constitutional medicine. The new information:
“I’m not depressed anymore. The Morton’s neuroma is much better, but it still feels like a wad in the bottom of my right foot. Thick and uncomfortable. Like clay. Massaging helps. It is irritating… I still feel sharp pain at night in my lower back. It wakes me up. Like if you hit me with a wooden stick. Like somebody punched me and hit my bone. Like a jolt to my back. If somebody knocked you in the chin and made you see stars. Like an unmovable part in the shoulder blade.” Helen had never before shared these sensations.
We asked what the Morton’s neuroma had felt like at its worst. “A sharp pain. Pinching. I couldn’t wear shoes. Like when you take something and pinch it. It’s all squeezed together. A lump that wasn’t movable.”
“I have hemorrhoids. It’s uncomfortable to go to the bathroom. Tender. I have to be really gentle and careful. Thin protection. It makes me feel irritated. It’s harsh. Hurtful. Painful.”
We delved more deeply into the pain. “Horrifying. You would want to leave your body. The pain is too horrible. Very sharp. Extremely painful. Hurtful. Something’s being damaged. It would be bloody, swollen. It could sting… harsh, mean… My dad used to hit me with a switch. It left red marks so bad that I couldn’t sit down and go to the bathroom. Extremely painful.” Helen then mentioned having nearly escaped a serious car accident as a teenager.
All of the references to pain and hurt suggested a Compositae, far different from the Anacardiaceae family. We considered which member of this plant family would best fit Helen, including the keratosis, and came upon homeopathic Calendula. Given its fame for lacerations, wounds, and post-surgery, we asked Helen about any history of surgeries. “I suffered a ruptured appendix 15 years ago. Surgery wasn’t performed until after it ruptured. I told the doctor that my siblings had also experienced ruptured appendices, but he didn’t catch it in time. I was in so much pain that I think I was not much in my body. Painful, sharp, intense. Five days later he opened me up and found the appendix had ruptured. I was very angry about the delay.” We changed the prescription to Calendula 30C daily.
Follow-Ups After Calendula
One month following the new prescription, Helen shared: “You know how I had brown spots all over? They turned scaly and are starting to disappear. I had gobs of them all over. Nothing else has ever worked in the past… I fell two weeks ago and ended up wracking my body. I am still sore. My hemorrhoids are 90% better. I also started using astringent pads.” We prescribed a dose of Calendula 1M for the contusion and Helen continued the 30C daily as well.
Three months later: “I was good until last night when my shoulder went out. I was hardly going to see the chiropractor. The keratosis is much better. I have about three spots on my face and one on my back. Still some brown spots but no flaky keratosi. My memory is so much better. So is the arthritis in my hands and toes. There is not as much leakage with the hemorrhoids even though I stopped using the astringent pads. I so appreciate your help. It’s wonderful.” She continued the Calendula 30C daily.
Nine months later: “A lot of my symptoms are better. My left foot, lower back, and shoulder blade are all less painful. Before I had keratosis all over my face, back, arms. I don’t see any on my arms now, my face is much improved, and my legs look much lighter. And my nose is so much better… I still suffer from anxiety, but not like before. My memory continues to improve. It seems like the remedy is even helping my toenail fungus.” We again prescribed Calendula 1M and Helen continued the 30C.
One year later: “The spots on my skin are even better. Just one the size of a dime on my right leg and it’s fading, too. The arthritis in my big toe is just about gone. That lump in my back, the one I was born with, is hardly there. The remedy is helping with the neuroma, too. I would say it is 80% improved from when we started. I think it comes form wearing hand-me-down shoes as a little girl that were too small for me… My hemorrhoids are getting steadily better, too.” Plan: Continue Calendula 30C.
One year and four months (most recent appointment): “I only have two or three small spots on my back. Before, they were all over. And on my mouth. They’re now 95% better. The scoliosis pain is also much less. The Morton’s neuroma is not bothering me like before. It’s no longer difficult finding shoes that fit. The arthritic nodule on my left foot has gone down in size. My M.D. tested my memory and says it’s fine. By the way, I don’t think I mentioned that my stools were black before. Now they’re a normal colour. And my fingernails are hard. I have to cut them all the time. Before they had ridges. They wouldn’t grow but just broke easily. That’s one of the first things I noticed with this remedy, ‘Wow. I’ve got fingernails that I need to cut!’
Helen continues to take the Calendula 30C liquid plussed as well as Calendula cream as needed.
The Value of a Re-take
Helen reminded us to not make assumptions about the prescription. Even though Rhus tox seemed to be the obvious choice and did produce improvement over time, we listened to our intuition that it was not the best homeopathic medicine for her. It is important to not hesitate to do a retake if there is any doubt about the constitutional prescription. And to do so without any prejudice about what might emerge. Continuing with a prescription that is producing only partial results, rather than reviewing a case to ensure it is new and fresh, is simply not the best we can do.
(This article is reprinted with permission from Townsend Letter: The Examiner of Alternative Medicine. Visit: www.townsendletter.com, write: 911 Tyler Street, Port Townsend, WA, USA 98368)
Judyth Reichenberg-Ullman and Robert Ullman are licensed naturopathic physicians, board certified in homeopathy. Their most recent book is The Savvy Traveler’s Guide to Homeopathy and Natural Medicine: Tips to Stay Healthy Wherever You Go! It is available as an app under the name “Natural Travel Doc.” Their previous books include: Homeopathic Self-Care, The Homeopathic Treatment of Depression, Anxiety and Bipolar Disorder, Whole Woman Homeopathy, Ritalin-Free Kids, Rage-Free Kids, A Drug-Free Approach to Asperger Syndrome and Autism, The Patient's Guide to Homeopathic Medicine, and Mystics, Masters, Saints and Sages-Stories of Enlightenment. New editions of Ritalin-Free, Whole Woman Homeopathy, and Homeopathic Self-Care are now available as well as Kindle and iBook versions and mini iBooks, of all of the books. The Ullmans live on Whidbey Island, WA and in Pucón, Chile, and practice at The Northwest Center for Homeopathic Medicine in Edmonds, WA. They treat patients by phone and video conference as well as in person. They can be reached by telephone at (425) 774-5599, or by email at email@example.com or firstname.lastname@example.org. Their website is http://www.healthyhomeopathy.com