A Curious Case of Hives and Narcolepsy

Dan itched like crazy. For the past two years, he had red, slightly raised, itchy patches all over his body, that looked like hives. They were on his back, both arns and his lower legs. He itched so much, he scratched until he bled.

He woke himself scratching every two hours at night and stayed awake for a half hour at a time trying to control the itching. It was better from a hot shower, followed by a cold shower which numbed the skin. The patches felt very dry. The itching was much worse if he became chilled. He was much more sensitive to cold  in general since the eruptions had begun. He felt restless inside, and tried to distract himself. The itching was worse if he ate cherry pie and icecream.

The hives started when the company he worked for went bankrupt and two hundred of his friends lost their jobs. He had always been very concerned for other peoples’ problems. He was all right now, but it saddened him that the way of life he had known for so long was gone. He was a hard worker and worked fifteen hour days at his new job as a salesman. He traveled a lot by car, making sales demonstrations. Whenever he could not sleep, he would get up and do paperwork until he got tired again. He thrived on new challenges and liked to ride his dirtbike for fun. He had chronic back pain and stiffness, from motorcycling and riding in the car on long trips.

Dan was given Rhus toxicodendron 6C, three doses a day. The hives with intense itching, restlessness, back stiffness and pain, chilliness and the fact that the itching was aggravated from the cold led to the prescription. Rhus tox, derived from poison ivy, is a major remedy for allergic reactions, hives and itching. We thought sure it would work. Two weeks after the remedy, Dan called to report that he was very sleepy. He became very sleepy during the day, and he now could sleep through the night. He still had considerable itching and tingling, and a lot of eruptions. He was working less and not so concerned with other peoples’ problems.

The new sleepiness was an unusual symptom, considering that Dan had so much trouble sleeping prior to the remedy. We wondered if the Rhus tox might be suppressing his symptoms, but it was too early to tell. He was instructed to decrease the remedy to once daily.

Two weeks later, Dan returned to report that his eruptions were still really bad, indeed they were worse. He had itching and burning after he scratched himself. He could sleep at night now. His skin felt very dry. He had tried sesame oil on his skin, which helped with the dryness. He felt chilly and quite restless. Twice a night he took a very hot shower followed by a cold one. He now felt better from cold applications, and better from being out in the sun.

His memory was much worse. He could not remember anything. He feared that he would not recover. He desired sweets. He was still aggravated by ice cream and cherries. He had to put oil on his skin or he would become anxious.

At this point it was clear that Dan was not better from the Rhus tox and in some ways he was much worse. He was sleepier, his memory had failed, and his skin had become very dry. He stlll had eruptions which tormented him, even though he could sleep better. We stopped the Rhus tox and gave a single dose of Dulcamara 200C. Dulcamara was a small remedy which was well represented in the repertory for Dan’s symptoms. It covered the urticaria, skin dryness, itching, burning after scratching, weakness of memory and desire for cold drinks. Other possible remedies we considered were Arsenicum album and Apis mellifica. The symptoms of the case at this point could have led to the correct remedy, but we did not see it then.

One month after the Dulcamara, Dan said he was somewhat better. The burning was gone and the itching was tolerable now. The skin was still dry, but needed less oiling. He felt better when his skin was covered. He still got up once a night to put oil on his skin. Now the itching was worse if he got too warm at night. He did not sweat much. He felt obsessed with his condition. He had slowed down a lot. He felt like he was going one mile per hour and the world was going a hundred. He still desired sweets. He still had eruptions on his lower legs, arms and torso. They were worse on his back. His skin felt bumpy. He was forgetting how to do some math and he felt sleepy while reading or driving. We assessed that the Dulcamara had only a partial effect at best. Dan was still worse than at his first visit.

We restudied the case and gave Alumina 200C. Alumina covered the slowness, weakness of memory and inabilitiy to calculate and particularly the dryness. Dryness is a major keynote of Alumina. It also had itching, dry eruptions, itching that was worse from warmth of the bed, and dry skin without perspiration.

At this point, Dan’s case was not going well, and Alumina seemed to offer the best hope of helping him to recover. The itching of Alumina usually occurs without eruptions, but we ignored that and prescribed it anyway.

Dan returned after two and a half months. He said that the eruptions went away two weeks after the remedy. He still had some itching on his back and arms. His mental functioning was back to normal. His energy was up and he was playing tennis. He relaxed more now and did not overwork. He no longer worried about other’s problems. He now desired baked potatoes, (an Alumina symptom) three times a week, and also still liked sweets. Eating cherries and ice cream together still bothered his skin.

The Alumina seemed to help Dan considerably, removing the eruptions for the first time in two years. What was even better was that his mental abilities returned. He retained a sense of relaxation and took life easier than he had initially. We waited for a month longer.

When he returned Dan still had some dryness and itching, but no eruptions, unless he ate cherries and ice cream which briefly caused some eruptions to appear. Everything else was the same. We decided to give Alumina 1M, the next higher potency of the remedy.

When Dan returned three months later, he had some eruptions on his back. They itched, but not badly. He could sleep through it. The eruptions were red, slightly raised and worse from getting warm or a hot shower. The dryness was still present and he had to oil his skin twice daily. He still felt chilly.

Dan felt bored with his work and could doze off easily while driving or having a conversation. His eyes would glaze over while driving and he would fall asleep. His wife had to go with him on his business trips to keep him awake. He was dangerous behind the wheel on long trips, due to this newly developed narcolepsy. His memory was also poor for new information, people’s names, and details of his business. He could remember things that he cared about, but whatever bored him was soon lost. His motivation was low. He felt too relaxed, almost dreamy. He felt indifferent to his business. He could be a couch potato and sleep a lot. He enjoyed country dancing, though, and had plenty of energy for that.

Dan’s increasing boredom, dreaminess and extreme sleepiness led us away from Alumina. Alumina had helped him, but some of the skin symptoms were still present. The sleepiness, memory weakness, dryness and skin eruptions finally led to a prescription of Nux moschata 30C, once a day. Nux moschata is nutmeg. It is known for the combination of overpowering sleepiness and extreme dryness. Both Alumina and Nux moschata are known for excessive dryness. Both have mental confusion and weakness of memory, but Nux moschata has more sleepiness. Although skin eruptions are not a prominent part of the Nux moschata picture, the remedy is listed in the repertory for dry eruptions, as well as suppressed eruptions. The sleepiness and memory weakness could either have been the result of suppressing Dan’s eruptions homeopathically, or the emergence of an underlying layer of symptoms which matched Nux moschata. Dan was given the remedy in 30C potency, the highest potency we had of this somewhat rare remedy. It might have been possible to prescribe Nux moschata earlier in the case when the sleepiness first appeared, but it is not a well known remedy for skin eruptions and so it was not considered at that time.

Three months later, Dan had improved, but still had occasional sleepiness in the car. His overall energy was much better. His eruptions disappeared one month after starting the remedy. He no longer had to oil his skin. He still felt his memory was poor for the details of his work, but not for what he was interested in. He occasionally lost the words he had intended to say. He had high motivation now and he said he liked his work again. He still liked sweets and was thirsty for water. He was no longer chilly.

At this point, it seemed that the Nux moschata had helped him considerably, but there was still some sleepiness and memory deficit. He was given a single dose of Nux moschata 200C.

After that dose, Dan was well for 8 months. Then his itching came back slightly and he began to get sleepy behind the wheel again on long trips. He was given another dose of Nux moschata 200 C which helped him once again.

In Dan’s case we see how it is possible to retrieve a case which was nearly lost. The initial remedy, Rhus tox seemed well indicated, but it only helped Dan partially, if at all. He felt more relaxed and could sleep better, but his skin eruptions were not relieved. Rhus tox may have suppressed some of Dan’s symptoms to the mental plane, causing the sleepiness, memory loss and excessive dryness. The Dulcamara, though it seemed indicated by repertorization, only had a partial effect. It did palliate the skin symptoms somewhat. The excessive dryness and weakness of memory which developed after the Rhus tox led to the partially successful prescription of Alumina. Alumina helped Dan considerably, both physically and mentally, but the mental improvement did not hold and his skin eruptions returned. Alumina was close, but not the best remedy. The sleepiness, which had been a relatively minor symptom at the time Alumina was first prescribed, came out more fully as the picture of Nux moschata emerged, with the dryness, dreaminess and sleepiness becoming quite prominent. Nux moschata returned Dan to health.

What is interesting to note is that when Dan was first treated he had restlessness, insomnia, overconcern with others and was very hard working, nearly driven. During the course of treatment, he mellowed, almost to the point of being comatose. This trend was a change that Dan valued, once his energy and motivation returned after the Nux moschata. He enjoyed being more mellow and not taking things so seriously. It took being slowed down by the remedies to finally make him slow down and enjoy life again. Whether the picture of Nux moschata emerged after suppression, or simply out of the innate wisdom of his vital force is unknown, but the net result was improved health and a better quality of life for Dan.