Yesterday I was working on a case of a 17-year-old girl who has an eating problem . She does not seem to be anorexic, but has difficulty with eating.
– She does not get hungry – she gets stomach cramps which is how she knows she must eat. She also gets a “mouth” sensation that she wants something “with a lot of taste”, but when questioned it turned out that some of the foods she likes that fall into this category include pasta with olive oil and mild flavouring, cheese Danish, and similar. Her concept of “a lot of taste” did not mean highly spiced or strongly flavoured.
– After she has eaten a small amount, she feels both full and disgusted with the food she has eaten.
I mentioned this case to Gary, and he asked “have you considered the rubric for desires refreshing food?”
Remedies for this rubric: Carb-an, Caust, Cocc, M-art, Ph-ac, Phos., Puls., Rheum, Valer.
The word “refreshing” has always put me in mind of watermelon, cucumber salad, chilled fruit juice, or (like the Brit I am), a strong cup of tea. But however much I love a really good shepherd’s pie, I have never considered it “refreshing”. However Gary’s question got me thinking: what does “refreshing” mean? And are the foods and drinks that come under this definition more or less objective – or is it an issue of why the patient requires a food (to refresh himself), rather than the nature of the food itself?
In this particular case I had considered remedies such as Lyc, Calc and Puls – which I had given to the patient on several occasions but which had never quite touched this symptom.
I did some research. The original German word is “erquickendem”, which a German linguist informed me is probably connected to Middle English terminology of “the quick and the dead”. Looking at thesaurus options for the word “refreshing”, I came across words such as “revive”, “restorative”, and I found myself remembering soporific events which people attended lured in by the hallowed words “refreshments will be served”… which often were far from refreshing in the sense I had understood it, unless insipid tea and dry buns fit the description.
I’m also reminded of the way my father would say sitting back in his chair after eating something substantial that he had really enjoyed, “that was fit to revive the dead…”.
Back to our (refreshing?) onions…
I took two rubrics in this case:
Hunger and Thirst, Desire, Refreshing (306)
Hunger and Thirst, Hunger, Appetite without (274)
These rubrics led me to Rheum, a remedy I had not considered at all in this case. The Materia Medica Pura includes these symptoms, amongst others, and in general Rheum reads very well for many of the other symptoms in this case.
49. Great appetite, but the food though tasting nice soon becomes repugnant. [Gss.]
50. Whilst he loathes certain things (such as fat, insipid food), appetite for a variety of things, but he cannot eat much of them, for they immediately become repugnant. [Gss.]
51. The food does not taste right, and soon becomes repugnant, though he has tolerable appetite. [Gss.]
53. Hunger, but no appetite.
54. He feels qualmish (squeamish, loathing and inclined to vomit).
There are two issues that I wanted to highlight in presenting this case:
1. Our understanding of remedies and symptoms are inevitably complicated by nuance of language, by the way the sensations are literally lost in translation, first from the sensation itself into spoken language, and second from one language to others. This applies both in the way our patients report their symptoms, and in the way the symptoms of the provers were reported as presented in the Materia Medica. It emphasizes the need to look at older meanings of words we may think we understand when using the repertory and when reading provings on which the repertory was based. And it also means that we have to use the question “what exactly do you mean by that” frequently in our case-taking.
2. The repertorization is not intended to summarize the case in two rubrics, and in this example, not even to identify all the most important aspects of this case. It is really a tool, intended to find some essential salient elements that will point a guiding finger towards relevant remedies that we need to look at in the Materia Medica.