Courtesy :Homeopathy in practice Winter/Spring 2013
Frequently one hears people joking about their ‘senior moments’ but, often, these moments cannot be laughed off any longer. Sometimes, family members ignore the early signs of dementia as these signs are not seen as ‘signals’. This is because they may alternate with periods of lucidity. There are occasions, however, when sudden mental decline slips in. Whether the onset is slow or rapid, this state is regarded as irredeemable by mainstream medicine.
The reason why it is extremely difficult to address dementia with any system of medicine is because one has no access to the pre-verbal period of sufferers’ early life. It is actually during this time when one’s ability to modulate stress is established.
Taking up the challenge
Homeopathy is one system of medicine, however, which may be able to address these states if:
1) Treatment commences as early as possible.
2) A friend or relative can explain the level and nature of trauma in the background, which correlates with the level of suffering. (Gabriel Garcia Marquez speaks of ‘the inseparability of past, present, and future’.)
3) A drug or toxicity layer can be exposed and removed through treatment.
4) A physical contributing factor is identified, such as a history of hysterectomy, insomnia, malnutrition, obesity, osteoporosis (on a physical level) or depression and grief (on an emotional one). Note that insomnia is an important trigger as not only can it influence obesity but also bone formation through its adverse effect on the adrenals.
5) Maintaining causes can be removed, for example isolation, junk food diet, sedentary lifestyle, lack of mental stimulation, stress.
6) A family history is elicited (miasmatic inheritance plays a vital role).
I would emphasise the much-used adage ‘prevention is better than cure’ in dementia, as it applies in such related diseases as diabetes. In fact, the latest research even goes so far as to describe Alzheimer’s disease (the most extreme form of dementia) as ‘diabetes type 3’ (arising through the same misguided lifestyle and emerging on the same trajectory).
According to an article in the ‘Review’ section of The Guardian on 28 August 2012, a report is quoted that states the following: Due to the fact that people are now living much longer (after all, the ‘baby boomers’ are coming of age at this time!) and, with the population explosion, degenerative brain illnesses presents a ‘national crisis’ (to quote David Cameron). Furthermore, he goes on to add that caring for these people has become ‘one of the greatest challenges of our time’.
The tip of the iceberg –
One of the reasons why Alumina has become such a ‘polychrest’ in these states is due to its ability to antidote the effects of aluminium in the organism. After all, it is only in recent years that aluminum has been phased out of cookware and utensils (it may still be contained in some allopathic medications).
A remedy, which closely resembles Alumina in its passive state, is Nux moschata. In Nux moschata, there is a more comatose state, but the same level of sluggishness exists. This is mirrored in both remedies through stasis of the bowels. There is a shared slow response when answering questions and a type of regression commonly seen in dementia. Many of the remedies discussed here cover this theme, although it is most marked in the Baryta salts.
The causative factor in Nux moschata could be ‘disappointed love’ and the confusion in this remedy often relates to finding locations – a type of disorientation (rubric ‘confusion, loses his way in well-known streets’). Glonoine is the main remedy in this rubric, which indicates its connection to Nux moschata. Therefore, Glonoine could easily be a satellite of Nux moschata if hypertension prevails.
Both Alumina and Nux moschata have a dryness running through them, shown in lack of perspiration, dry skin eruptions, and thirstiness. These symptoms indicate that dehydration has a major effect on the functioning of the brain (after all, the brain is composed of 80% water).
Alumina is a syphilitic remedy, and has more depression than Nux moschata, as demonstrated in the rubrics ‘smiling, never smiles’ and ‘repulsive mood’. The emotional causation could be scorn – see rubric ‘ailments from being scorned’, as opposed to ‘ailments from disappointed love’, reflected in Natrum muriaticum.
The Baryta salts are indicated in the passive state of dementia. Of course, these remedies are the main ones indicated for childishness (see rubric ‘childish behaviour in elderly people’). Often, the Baryta patient hides behind a carer or relative. There may be accompanying physical pathology such as hypertension or sclerotic changes (the latter especially in Baryta muriaticum). The timidity in the Baryta remedies is more marked than in Alumina. There is a similar sense of disorientation here, as seen in Alumina as well as Nux moschata. In Alumina, one sees ‘delusion, everything seems unreal’. In the Baryta salts there is ‘delusion, everything is changed’, and ‘delusion, familiar things seem strange’. In Nux moschata, this delusion is more exaggerated, as expressed in ‘delusion, familiar things are ludicrous’.
Plumbum metallicum is closely related to both Alumina and the Baryta salts. The Metallicum remedies are known for their marked level of weakness; so, if the patient is very weak and has not responded to one of the above indicated remedies, then consider giving Plumbum metallicum. Note that this remedy is contained in the rubric ‘repulsive mood’ alongside Alumina (as well as Ambra grisea and Conium to be discussed later).
If there is physical pathology, Plumbum metallicum is more likely to affect the upper extremities, whereas Alumina relates to the lower extremities. This remedy is well known for Parkinson’s disease, when everything literally slips out of the hands (a symptom which is very symbolic of old age) and reminds one of the related remedy Conium maculatum. This disease can affect the functioning of the brain structures, with its depletion of dopamine (the ‘feel good’ neuro- transmitter).
So, dementia, in these cases, could be covered by this level of undermining. The stasis seen here reflects on the bowels in an even more extreme way than seen in Alumina and Nux moschata. Sometimes, there is complete impaction, and only manual evacuation will relieve the patient. I should point out that, as long as there is weak elimination in any remedy picture, the mood will be low and the cognition will directly suffer the consequences.
A type of paranoia can erupt in Plumbum metallicum – reflected in ‘delusion, everyone around him (see box below) is a murderer’, and ‘delusion, he is about to be arrested’. The extreme confusion can lead to ‘errors of personal identity’ (like Alumina and Kali bromatum). However, in Plumbum metallicum this state is more extreme – see rubric ‘delusion, errors of personal identity, thinks she* is someone else’. Like the Barytas, there is dislike of being alone (Alumina and Nux moschata are, opposedly, averse to company).
* Kent was a little confused about genders in his description of rubrics, although more women than men succumb to the disease.
After a lifetime of burning the candle at both ends in the style of Medorrhinum or Tuberculinum, the Conium maculatum state can develop. How can old age be embraced when the whole focus has, till now, been so materialistically based? This culminates in difficult understanding and an indifference to the environment (like Helleborus niger). In the same way as depicted in the related Baryta salts, imbecility can take over. Other remedies mentioned here which are also black type in the repertory under ‘imbecility’ include Alumina, Ambra grisea, Hyoscyamus, Nux moschata, and Opium. Note that Conium maculatum can secure the work of the Barytas if the action of the latter salt does not hold or work in the first place. The arteriosclerosis noted in this remedy becomes reflected onto the emotional level in its hardening. This could be due to loss of property (the latter symptom also seen in Aurum metallicum and Kali bromatum), effects of alcoholism (Anacardium and Hyoscyamus are also noted here) or cessation of sexual activity.
The disappointed love seen in Conium maculatum overlaps with Natrum muriaticum and the marked guilt parallels that seen in Aurum metallicum and Kali bromatum. Conium maculatum resembles Plumbum metallicum in its inclination to sit – see rubric ‘sit, inclination to’ – and slowness in motion – see rubric ‘slowness in motion’. Constipation is a theme seen in this remedy, alongside many of the other remedies mentioned here.
The Kali bromatum state can emanate from many different causations, ranging from strokes on a physical level, to business failure, death of friends, loss of property, or reputation, on an emotional level.
There is a type of regression that occurs, as in the Baryta salts. In Kali bromatum, it is accompanied by a sense of foreboding, seen in the ‘delusion, of being doomed’. (Hyoscyamus and Opium have this symptom to a lesser degree.) They can also have the ‘delusion of being pursued’ (like Anacardium, Hyoscyamus, and Plumbum metallicum). It could be the outcome of a religious crisis in Kali bromatum (as seen in Aurum metallicum). Being a deeply syphilitic remedy, insomnia can prevail and an extreme sensitivity to pain (as opposed to Opium’s indifference to pain).
As the dementia state progresses in this remedy, the patients may not be able to recognise their friends or relatives – as seen in Alumina, Anacardium, the Baryta salts, Hyoscyamus, Opium, and Plumbum metallicum. This can be quite disconcerting for those who care for them (see rubric ‘relatives, does not recognise’).
A noted symptom is their restlessness, often wringing their hands or keeping busy in the form of knitting (if they are ‘compos mentis’ enough to do this). Like Anacardium, alcohol could be the underpinning trigger to their state.
The carbon remedies are well indicated for dementia, Graphites being a significant one here. Calcarea carbonicum is very well indicated for insomnia in old people but, as a remedy, does not bear repetition well at this stage of life. The theme of constipation applies to Graphites and the digestion is weak. There can be skin disease or cancer in the background and emotional triggers are fright or grief. If the patient is very weakened by cancer, Carbo animalis may be the operative related carbon remedy here. Of course, Conium maculatum is the main remedy for cancer due to the shutting down which occurs in this remedy at this stage of life.
As is so typical in dementia cases, the Graphites patient often recalls all the events of youth, but nothing about recent ones. There is a pessimism – thoughts of death, relief from tears, dwelling on the past (like Ambra grisea and Hyoscyamus), irresolution (black type), and vertigo (as seen in Ambra grisea, the Baryta salts, and Conium).
Ambra grisea is black type in the rubric ‘lack of reaction’. The other remedies mentioned in this article are in italics, although Conium maculatum is the only remedy in the rubric ‘lack of reaction in old age’. This is a markedly timid remedy, to the point of suspicion, and one where there is much dwelling ‘dwells on past disagreeable occurrences’ (Natrum muriaticum is not the only remedy indicated here). There is focus on the bowels in this remedy, like Alumina and Nux moschata, with the marked distress from being observed during stool – rubric ‘company, aversion to, people, intolerable to her, during stool’ and ‘anxiety from ineffectual desire for stool’.
Opium is also a good remedy to ‘unblock’ cases where the bowels have become completely inactive. This could be traced back to a trauma, drugging, alcohol poisoning, an anaesthetic procedure, or a stroke. There is complete indifference, shown in the rubric ‘asks for nothing’ (Alumina and Hyoscyamus are less reputed for this symptom). There is an inability to experience both pain and / or pleasure. This indifference to pleasure is mirrored in Helleborus niger, a remedy where the brain may have been affected due to encephalitis or meningitis, or a head injury. There may also be a history of disappointed love – see rubric ‘ailments from disappointed love’.
The state in Helleborus is almost coma-like – shown in the rubric ‘stupefaction’. The patient may pick at the bedclothes (like Hyoscyamus). There could be a background of a stroke to this condition (like Opium). In one case, the patient had been abused by her husband and had possibly received a head injury as a result. After his death, with the introduction of the remedy, coupled with a loving carer, her revival was quite startling.
The Hyoscyamus state could also be induced by disappointed love (in addition, there could be a history of abuse in the latter remedy). The patient may have become damaged due to alcoholism or drug addiction. There is a foolish hilarity seen here, with possible jealousy and suspicion. The state can be quite manic with erotic overtures. This can lead to shameless exposure of the genitals. The mania can be so extreme that the patient does not recognise anyone and tries to escape. Often they refuse to take any medicine, such is their suspicion. This can be translated into the rubric ‘eat, refuses to’. Imbecility is unfortunately a natural progression for these patients in their full-blown state.
Crot. horridus is another restless remedy (belonging to the snake family); the patient can be suspicious (like Hyoscyamus), with preoccupations about death. Their loquacity with desire to escape can overlap with Hyoscyamus. Sleep disturbances often predominate and the speech can become incoherent (reflecting their trajectory to imbecility). They may desire company but become averse to members of their own family.
Osteoporosis can be a contributing factor to the onset of dementia. If bones are decalcified, this means there is not adequate nutrition circulating in the system. This depletion of nutrition can also affect the brain structures – especially the hippocampus – that structure directly responsible for memory. If fractures occur as a direct result of osteoporosis, the shock and limitation this places on the patient can propel them into sudden mental decline. There is extra release of cortisol, which undermines this very brain structure.
A remedy I find useful here is Selenium. I recently treated a 65-year-old male with this remedy. He had developed osteoporosis as a direct result of using anti-epileptic medicine for most of his adult life. He had developed marked depression, impotence, and weight loss. He could no longer travel to his holiday home in the Mediterranean in the summer as the heat had become unbearable to him (Selenium is markedly weakened by the effects of heat). I noticed that he had taken on the appearance of a much older and weaker man than warranted for his years. At the same time, I remembered this remedy’s indication for early impotence and premature senility.
The patient had developed a dread of people and inability to work (he had been an artist up to a few years prior to the illness). After the remedy, not only did he become more engaged with his libido, and life in general, but also he felt able to return to his holiday home and renew his painting career.
I should point out that there is a direct relationship between Lycopodium and Selenium. They are linked through the emaciation and impotence, as well as the presenility.
The use of bowel nosodes
The bowel nosode related to Selenium is Bacillus No.7. This remedy is based on extreme fatigue, as well as fibromyalgia (this latter state often reflects a ‘somatisation’ from unexpressed emotions). There can be a picture of osteoporosis and / or osteoarthritis in this remedy. The blood pressure is low and the heart can be weak. The digestion is slow and senility can come on prematurely. In the background to all this, there could be a picture of hypo-thyroidism, a state which can predispose the sufferer to dementia.
In fact, all the bowel nosodes work well in cases of dementia. Morgan pure is also a great energiser and promotes detoxification through the liver. I have found Morgan to be even better than Sulphur in clearing out a drug layer. It is especially good for expelling the toxic effects of steroids. There can also be osteoporosis and / or osteoarthritis in the picture.
With the high levels of stress often contained in the history of dementia cases, Proteus bacillus is the corresponding bowel nosode. This especially applies when a persistent ‘siege-like’ state of tension has prevailed in the past. In this case, the blood pressure may be heightened and a Nux vomica type state may have been prolonged in the patient. Just as there is slowness in the Bacillus No.7 state, there is a sense of hurriedness seen in Proteus bacillus. Even the onset of dementia can be sudden in these cases. The arthritic symptoms often combine with the elevated blood pressure to induce intermittent claudication, a clear sign that there is some blockage of the arteries.
With the high level of gut impermeability often seen in the elderly, combined with the frequent drug layer, bowel nosodes are an excellent way to kick-start the treatment and support it from time to time. This especially applies when the diet is poor and it is evident that the patient is not absorbing the full nutrients they require from their food intake.
A remedy which also has affinity with the gut, and which may apply in dementia cases, is Anacardium orientale. The patient is always relieved, both emotionally and physically, by eating. Often, in the background, there is a history of domination or humiliation, creating a split within the patient (see rubric ‘ailments from domination’). This leads to great undermining of the self-confidence of the patient. Both the concentration and memory can become impaired from quite a young age, compounding the low self-confidence the patient is already experiencing. Maybe the brain has become weakened by the overuse of alcohol.
When the aggression kicks in, which can be quite a marked symptom of dementia, this remedy could come into its own. It is reputed for patients using foul language. Like many of the remedies mentioned above, there can be marked constipation – in this case, with a plug-like sensation. There is some regression in this remedy and incoherent speech, like various remedies discussed here, and some paranoia (like Hyoscyamus, Kali bromatum, and Plumbum metallicum).