Clinical Cases

Comments on Prescription: Case of Maddie

Last modified on December 16th, 2012

Comments on Prescription: Case of Maddie

Sudden Onset

You (Elaine) suggested ‘When you hear “sudden onset”, three remedies should pop into your mind: AconiteBelladonna and Baptisia. Already, from 3000 remedies, you’re down to 3, just like that!’

I think, the assertions are too restricting, and would lead to failure in many acute cases. In reality, it’s not true in every case of sudden onset. I would definitely think of Colocynth in a case of sudden colic, which makes the patient bending double. There could be several such examples.

Most importantly, under the rubric “Sudden Manifestation“, Synthesis 8 (SE 8) gives 50 remedies, and Rpertorium Universale (RU) gives 63 remedies – strange enough Baptisia is nowhere in either of the lists!

The idea of “suddenness” in case of Baptisia is not unknown to any homeopath who has gone through this remedy attentively. The “suddenness” accompanies a severe symptom-complex.

The most eloquent description is found in Kent. Vithoulkas’ MMV also offer a lucid presentation on it. However, I would like to quote from the latest (probably) in our literature: Dr Robin Murphy in his Keynotes of the Materia Medica says, “The person slips into this zymotic state very quickly. Sudden onset (Aconite, Belladonna, Baptisia). Aconite and Belladonna slip into an inflammatory state. Baptisia slips very quickly into a zymotic state, into a septic state.”

In fact, “sudden onset” only does not count for Baptisia, “sudden onset of septic (zymotic) state” points towards Baptisia. And the zymotic/septic state has many well-marked symptoms, which are known to any careful homeopath, I believe.

Baptisia as of Morrison’s Desktop Guide

Well, Dr. Morrison has put nothing new (but may be, in a bit well-arranged manner) about Baptisia. If I re-arrange the cardinal points of Baptisia from his version, it looks like:

– Mainly seen in serious infections

– characterized by a ‘drunken’ or ‘besotted’ condition

– patient is sleepy or even stuporous ……..

– usually …. will appear in septic conditions

– may be indicated in less severe infections such as influenza ……

– RAPID ONSET OF SEPTIC STATE.

I am not sure of which repertory you have mentioned about. But the following rubric is already there in SE 8:

GENERALS – SEPTICEMIA, blood poisoning – appearing suddenly (BAPTmrr1)

Without any accompanying/ confirmatory characteristic symptoms of severe infection (e.g. Septicemia) or less severe infection (e.g. Influenza), I would like to rule out the possibility of Maddie’s sickness from an infection, having the least possibility to be of ‘septic state’.

There is clear difference between the terms “rapid” and “sudden”. I am not going into that topic for the time being to make our lives a bit easier.

Lethargic, stuporous appearance

Lethargy means “A state of sluggishness, inactivity, and apathy”. I would like to analyze the lethargic state a bit methodically. To do so, I would confine my extractions mostly on SE 8, mentioning RU only in cases with different results:

MIND – INACTIVITY (35), with Baptisia only 1, 5 remedies having 2;

MIND – DULLNESS (440), Baptisia 3 with 37 other remedies having 3, 76 remedies having 2;

MIND – INDIFFERENCE, apathy (357), Baptisia NOT mentioned! 22 remedies having 3, 68 remedies having 2;

(RU mentions of Baptisia with a 2, where dozens of remedies are listed with 3 and 4!)

MIND – INDIFFERENCE, apathy – desire, nor action of the will; has no (4) Baptisia Not mentioned; 2 remedies having 2;

MIND – INDIFFERENCE, apathy – external impressions; to (5) Baptisia Not mentioned; 1 remedy having 2;

MIND – INDIFFERENCE, apathy – external things; to (33) Baptisia Not mentioned; 1 remedy having 4, and 3 remedies having 2;

MIND – INDIFFERENCE, apathy – lies with eyes closed (4) Baptisia Not mentioned; 1 remedy having 2;

MIND – STUPOR (142) Baptisia is a 1! While 10 remedies having 3 and 39 remedies having 2.

Let’s consider that Maddie had a ‘drunken’ or ‘besotted’ expression – characteristic of Baptisia (which I don’t think really – after going through the case record several times, carefully!):

MIND – STUPEFACTION (278) Baptisia is a 3, with 14 other remedies having 3, and 47 remedies having 2

FACE – EXPRESSION – intoxicated (25) Baptisia is a 1, with 8 remedies having 2!

Repertorizing the above 10 rubrics having ‘GENERALS – SUDDEN manifestation (50)’ on the top of the list, is it not extremely difficult to come up with the idea that Baptisia is

THE simillimum?

So far the descriptions on Baptisia are found in very trustworthy materia medicae, the “besotted” appearance of face of Baptisia is almost invariably conjoined with other striking features:

– Face flushed, dusky, hot, dark-red, with a besotted expression. (Clarke)

– His countenance is besotted. It is bloated and purple and mottled. (Kent)

And all these are the features of a very serious infectious state. Besides “just looks sad and droopy”, we do not find any such accompanying expression of symptoms in Maddie.

Maddie’s lids looked “pinkish” only – not even the whole face! Without looking at the patient, how could someone imagine that the patient had been “stuporous”!

My Comment

For the sake of argument, let us consider that Maddie contracted some sort of gastro-intestinal infection, which caused her pretty severe vomiting and the lethargic state. Even then, what would be the most expected condition in a child of 3 or 4 who vomited four/five times – all after eating or drinking (esp. immediately after drinking cold water)?

It would be very normal that the child would be exhausted, weak, sad looking, lethargic and …… may be droopy. Do these really point towards Baptisia? If Maddie had been cheerful after the episodes of vomiting, I would rather consider that as a striking, peculiar symptom being characteristic of the patient during the acute suffering.

Again, for the sake of argument, let’s consider that Maddie had food poisoning (for which, Baptisia is a good remedy). What would be one’s expectation of symptomatology to take into account? Besides the Generals and Mentals, should we forget absolutely about the characteristic features of the vomiting as of Maddie’s?

STOMACH – VOMITING – breakfast – after (11)

STOMACH – VOMITING – drinking – after (82)

STOMACH – VOMITING – eating – after (119)

STOMACH – VOMITING – drinking – cold water; after (33)

STOMACH – VOMITING – drinking – immediately after (13)

GENERALS – FOOD and DRINKS – cold drink, cold water – agg. (108)

Strange enough, none of the above rubrics contain Baptisia at all!!

At this point, one may argue that in an acute case of such moderate intensity, we don’t get so much time to analyze all the minor details ……… etc. I would like to say that we couldn’t afford to be ex tempo while prescribing homeopathically. Some acute cases may demand on the spot prescriptions; without having mastered in treating those conditions homeopathically – one must not dare!

Another point may be raised that I am suggesting merely of mechanical repertorization (or just matching of symptoms), which has nothing to do with ‘classical’ homeopathy. In fact, I am very much aware of this sort of stuff. I just wanted to put the things of interest methodically.

Before closing this write up, I would like to put here few lines on Baptisia as described by Dr George Vithoulkas in his MMV:

“The characteristic generalities of this remedy are:

a. an all round sick feeling

b. great muscular soreness, bed feels very hard

c. insensibility

d. mental confusion

e. prostration and

f. offensive discharges, offensive breath, stool, urine, sweat, etc.

…………………………..

Some keynotes for Baptisia:

– A feeling as if the forehead or the eyes or both were being pressed in.

– A tendency to rub the forehead constantly.

– A feeling as if the tongue were scalded.

– Swelling at the base of the tongue.”

Of course, Dr Vithoulkas has also mentioned: “This does not mean that Baptisia cannot be prescribed unless such a state of confusion is present. Behind such a description lies an idea or a “picture” of the kind of confusion and disturbance that this remedy can produce.”

I strongly think, the case record of Maddie does not produce any such image of sickness, confusion and disturbance (i.e. the sick “picture”), which is similar to Baptisia’s sick image of the acute type.

Concluding remarks

– “sudden onset” theme has been considered inappropriately

– weakness, lethargy, etc. have been over-rated

– absolutely no attention has been paid to the characteristic gastro-intestinal disturbance – featuring intolerance to any food or drinks, especially of cold drinks.

Mir Mostafa Kamal

Dhaka, Bangladesh.

— Elaine Lewis’ Reply —

Thank you Dr. Kamal for your review of the remedy Baptisia.

You stated in your fourth paragraph:

The idea of “suddenness” in [a] case of Baptisia is not unknown to any homeopath who has gone through this remedy attentively. The “suddenness” accompanies a severe symptom complex. The most eloquent description is found in Kent. Vithoulkas’ MMV also offers a lucid presentation on it. However, I would like to quote from the latest (probably) in our literature: Dr Robin Murphy in his Keynotes of the Materia Medica says, “The person slips into this zymotic state very quickly. Sudden onset (Aconite, Belladonna, Baptisia). Aconite and Belladonna slip into an inflammatory state. Baptisia slips very quickly into a zymotic state, into a septic state.”

Robin Murphy was my teacher, and this is exactly what I learned from him and the main reason I thought of Baptisia in Maddie’s case; otherwise, I never would have thought of it, and would have been stumped, and probably would have given Gelsemium; so, I feel very fortunate to have learned from him.

When I saw that nearly everyone who wrote in was unaware of Baptisia’s “sudden onset” characteristic, I was glad to have given this case and to have hopefully furthered people’s knowledge of this remedy. Now you, also, have furthered our knowledge of it. Thank you for submitting this article.

By the way, just a tiny disagreement with you….I did feel that the mental state was “characteristic” and not common. You said that it would be common to be lethargic after vomiting four or five times; however, for a small child, I think it would be more common to be crying, clinging to Mom, and desperate; I felt, consequently, that the “Baptisia lethargy” stood out very strongly as being “characteristic” in the case. When I read this case, I immediately saw two things: extreme lethargy and sudden onset of a “flu-like” state, and that, to me, spelled Baptisia.–

Elaine Lewis

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Mir Mostafa Kamal

Mir Mostafa Kamal

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