Two days I took a local trotro (taxi van) up to the Volta region on the border of Togo and Ghana. A local pastor there is also a homeopath in training and I went there to see patients and follow up on other patients seen by Indian doctors the previous month. They had been inundated with patients when here so I was hoping it would be a bit mellower. Fortunately it was but today we still saw about 12 new patients and 7 follow ups so we were busy. As I’ve mentioned, taking cases here is rather different but still the basics have to be followed. Simply, people have less to say about themselves usually. Most people are farmers or other forms of laborers and live simple lives. Many of their conditions are work related e.g. back problems from bending over or neck problems from carrying too heavy weights on their head, but there are still quite a wide complexity of cases to see.

We did the case taking in a big cavernous church which was no way near completion. Sand on the floor, no doors, no interior decoration, simply concrete block walls and a tin roof and people sat on benches around the church while we took the cases.

One 76 year old man came with partial paralysis, down the right side of body. He has pain in right side of body and his leg feels heavy and as if swollen. He said he feels as if there is a blood clot there. It began 9 years ago when he suddenly fell off his motorbike, and became unconscious. He woke up with numbness down the body. I asked him if he had been diagnosed with a stroke and he said no – but as I’ve noticed, people rarely are told what is wrong with them. He said he now moves more slowly around and that “it divides me into two.” He can feel hot all over and takes his clothes off in the house. That was about it. No strong food or weather desires. Most people prefer the cooler weather. It is very hot here most of the time!!
So I focused on right sided paralysis, assuming it was a stroke as well and went for the statement of thinking there is a blood clot there. So I gave Crotalus horridus 30c, liquid, daily. I would have given an LM but we didn’t have it.

Another case, a 30 year old woman came with insufficient respiration, as she said. It seemed to start after having her kid, which she said she had an operation for. It turned out she had a C section, although this was her 3rd child. Now she says her breathing can stop. Her husband says that when she’s asleep she makes a noise, as if she wants to wake up but can’t. She said she knows what is going on around her but can’t wake up. Her breathing seems to stop when she’s asleep. This happens around once every two weeks. I asked her what happened during the birth, did she have any anesthetic and she said she only had an injection in her back, presumably a spinal tap. I asked her whether she had any fear during this time and she said, yes, she was very afraid that she would die. Now she’s afraid even to go to sleep. I asked also if the noise she was making during her sleep was snoring and her husband said yes, although she used to snore anyway. He said the noise is also one as if she is trying to wake up but can’t.

So, I used the etiology of fear and fright along with the rubric respiration, arrested, sleep during, and sleep, waking, impossible and Opium is the most obvious remedy here. I gave Opium 1m sp dose. Aconite and Tabacum are other possibilities.

I then treated the local blacksmith who came with stomach symptoms and skin sx. He said he gets some blood in his stool, he goes 2/3 t a day, but the stool is normal. He hears a gurgling in the abdomen before stool. Four years ago, he was sicker with more blood in stool and then went to hospital. Of course, no diagnosis was given.
His other major symptom is intense itching behind the testicles (perineum). He scratches it until it is raw and also has itching in the crease between testicles and thigh. He said his erections are much less since then. He can also get pain in the meatus of penis after urination, like a wound. (many people here describe things as if a wound, so I don’t take it very individually). Two years ago, he had numbness in his feet and body. He says his body can feel lazy, not wanting to do work (he is 47 and has worked as a blacksmith for a long time. This is very physical work.) if he gets annoyed, he has to leave the premises. He likes things in order. If he doesn’t leave, he may react badly if he is feeling angry. Food: he is aggravated by cassava (which everybody eats all the time. It may be like wheat in the west now where people are eating too much of it and reacting to it.) he also is aggravated by alcohol. He used to drink but it makes him feel bad. He can’t work the next day and it changes him emotionally.

So here, I went for the three legged stool approach. Skin, itching, intensely in perineum and inguinal area, easily angered and aggravated by alcohol. Petroleum is the most indicated remedy and I gave it in 30c, SD for 3 days in liquid, to be repeated in one week if necessary.

Then there was a 45 year old woman, who came with right sided numbness of arm and leg for one year. She had a history of typhoid and now still has stomach sx, which is < cold food. She has a wound feeling in the stomach and pinching pain. She has a vaginal discharge, which is < with stomach sx. She has difficult breathing, which comes with fever, once a month, or every 2-3 weeks. She gets a weakness in the body and has a heaviness in her right arm. With the fever, she gets a bitter taste in the mouth and wants to ly down. She can’t work for 3-4 days with the fever and takes antinflammatories. This has been coming for 6 years now. With the fever, she feels hot and also chilled and wants to be covered. She is less thirsty than normal.
Her only other worry is that she is now 45 and seems unable to have a baby with her 2nd husband as she has blocked fallopian tubes.

So, I focused on the fever symptoms, which seems connected to the typhoid she has had and may also be malaria because of the periodicity of the fevers. The weakness, numbness and type of fever, especially with the chill and no thirst indicates Gelsemium, although I compared with Pyrogen and Rhus tox and Bryonia. The one contraindication was that Gels is not in the rubric, respiration, difficult, fever during, but lets see what it does and maybe another remedy will follow.

Another rather similar case is of a 45 year old woman who came complaining of great body weakness and heat sensation, and with the weakness has to be helped to stand and even to eat. She then said that she only had this the last time of an attack, although the attacks have been going on two years now. In the last two weeks, things got , and she had runny stool, going 10 times a day. She went to hospital and the Drs said she had malaria and gave some medicines. Now she has stool 2 times a day, but it is slimy and some odor. Before the odor was much <, it was unbearable.

Now when she gets a fever, she gets a biting feeling in her knees and joints and then a dry heat sensation. She says she feels confused with the fever and she feels weak, and can fall asleep. She has joint pains, and needs to stretch her arms. She has some numbness in the right hand and r. leg, which is < with her menses.

So, given the history of malaria, the horrible runny offensive stool and the recurrent fevers and weakness and confusion, I began the case with Pyrogen 30c, SD for 3 days, and then to be followed by Baptisia LM 1 daily afterwards. I am using the Pyrogen more like a nosode here but it has the extremely offensive discharges and the malaria state, but then the confusion with the heat and other symptoms seem to fit Baptisia well with Muriatic acid to consider if the weakness gets even worse again.

One case yesterday we had was a 36 year old man, a teacher, who came with piles. He also said he has some burning pains in the skin around the kidney area. He gets body itching, all over the body. It feels inside the body, so doesn’t feel relief from scratching. He has itching of the eyes, for 2 years, as if sand is in the eye. The skin itching is <in the heat. He generally likes coldness. He said he can get annoyed easily, but quickly forgets. He can be impatient and can tell people how he feels. He likes being alone. He is a primary school teacher. He does things fast in his work. Likes doing things the right way, in good order. In his dreams, he is often eating or going to the bathroom. There are no issues in the dreams doing these things.

In this case, I felt I got a good idea of the man, and his symptoms. The itching, the restlessness, the easily annoyed, impatient etc and Apis seems a clear remedy for him. So I gave Apis 30c daily for 3 days and to then wait and see.

One other case, a 28 year old female, had symptoms from a miscarriage in January 2009. She was hospitalized afterwards for two weeks for a fever and abdominal swelling but they didn’t do a D and C then and told her to come back which she didn’t as she couldn’t afford to go back. Now she feels a burning pain in the uterus, like a dragging upward feeling. Since then her menses have been darker and slimier. And not regular. She says it feels different now inside her vagina, around the cervix. Her body can get hot at night, she has to cool herself down with cool towels. This is since the miscarriage.

So, here I felt we needed a remedy for miscarriage and for unresolved infection in the uterus. The most clear remedy to me was Secale, included the increased heat, the dark menses,the burning pain in the uterus etc. So I have Secale LM 1 SD daily. I will keep Sabina in mind if another remedy is needed.

Another case I had was a 66 year old man who I debated between Lycopodium, Thuja, and Selenium for. He came with sexual weakness, with weak erections and urinary/prostate symptoms. He has sudden urging to urinate which he has to hasten or will lose urine, he has some dribbling after and has pain at the end of the penis, a burning during and after urination. Occasionally the stream can be forked but it is not strong. Food desire are a craving for sweets and and rice and aglan ( the local ground cornmeal, which they all love) and has an aversion to cassava, and beans. Mentally, he likes company, and doesn’t hold anger. It was rather a crap shoot between the three, but the keynote aversion and aggravation from beans gave Lyc the edge here. It is one of the few cases where food desires have helped me, either here or in the USA. Mostly I don’t find them that useful. So Lycopodium LM 1 daily and we shall see.

A 58 year old man came with a right sided inguinal hernia, which makes him have to lie on his back at times when it’s bad. He also has pains in the umbilical area. He can get a gurgling noise in the right side when crossing legs. Pain comes 3-4 times a day. The pain is like a tightening feeling. He had a history of stomch problems, with pain in the umbilical area, and he would vomit any medicine. He could vomit any food and drink as well with the pain.
He can get heat in the body, and has to pour cold water on his body. This can be day or night. But this can be more in the evening. He gets heat with perspiration.
He has 9 kids and two wives and is a farmer. Mentally, he said he is social, likes playing, and is not irritable. We didn’t really believe that last thing he said. He looked quite the irritable type. Given the hernia and the nature of the pain being tightening and the type of pain he used to get in the stomach with the vomiting of everything, we felt Nux vomica is the most obvious remedy here. So we gave Nux vomica LM 1 daily. We shall see.