Nicotiana tabacum as a homeopathic remedy
  

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By: Johannes Wilkens
WIilkens tobacco final.docTranslation by Peter Luborsky 

Abstract

Nicotiana tabacum was one of the plants most valued by Rudolf Steiner, yet no case reports on its use either from anthroposophical or from homeopathic medicine have appeared in recent years.

Experiences gleaned from toxicology and the practical case reports of Ita Wegman from her collaborative work with Rudolf Steiner, which were put down in writing by Hilma Walter, point to a broad range of applications.

Personal experiences are presented that justify its use particularly in cases of "deformation" of the personality, or "suicide on the installment plan."

• Key Words

Hypoxic disorders

Death experiences

Single-case study

The History of Tobacco

On October 12, 1492, Christopher Columbus discovered America. Within days of his landing on the Bahama Islands, he was struck by the observation that some Indians carried with them dry leaves, "which must be highly prized among them since they brought me the same thing in San Salvador"(1).

When his scouts Rodrigo de Jerez and Luis de Torres returned from the interior on November 6th, 1492, they were in a position to report that many men and women held in their hand a burning coal of smoldering aromatic herbs. One end of this they would light, and from the other end they sucked in the smoke, by which practice they became intoxicated and also apparently immune to fatigue. The "burning coals," the original form of the cigar, were called tabacos by these people.

Gonzales de Oviedo y Valdez, a friend of the discoverer of America, reports: "Among their vices the Indians practice a most pernicious one that consists of taking into themselves a kind of smoke, called by them tabaco, in order to put themselves into a stupor. For this purpose the caziques take a tube forked in the shape of a Y, inserting the two ends of the fork into their nostrils and the tube into a smoldering herb. In this fashion they draw in the smoke once, twice, three times, four times—as many times as they can before they drop senseless, stretched out as if inebriated on the earth, where they fall into a deep and heavy sleep" (2).

Tobacco pipes were used in North America, while cigarillos wrapped in a maize leaf developed in the Andean region. Paper was first used as a wrapper in Peru in the middle of the 18th century. From seafarers and the "common" people smoking quickly spread through Europe, eventually reaching even the ruling caste. Initially the pipe was the norm, later the cigar, and finally—since the end of World War II—the cigarette.

The pipe, with its head, is preferred by the intellectual (E. Bloch) with his orientation to the head pole. The cigar (swollen chest) is associated with individuals who like feeling important and powerful (Castro, Schwarzenegger, Clinton, Schröder). The cigarette, finally, is the "fag" or "light" of the masses, a nervous limb that is very well captured by the "HB-Männchen" of German cigarette ads in the nineteen seventies. A further "democratization" has taken place in cigarette smoking: It is now more common among women and young people than among men.

Mythology

Among the Aztecs and Toltecs the following myth was told: The goddess Cihuacoatl brought the tobacco plant from the sky. The rain clouds were to them the smoke that the rain god Tlaloc let out of his pipe or his immense cigar of rolled tobacco leaves.

Among the Maya it was the Balam, the gods of the four winds, who devoted themselves to smoking. When they struck fire to light their tabagos, violent thunderstorms swept the world. Tobacco was sacred to the Indians. It was a stimulant used in religious ceremonies or for states of exhaustion. With its help they sought access to the nature divinity (the wind-rain divinity).

Effects and Toxicology

From the start, there has never been a lack of voices decrying smoking. For a long time the smoking of tobacco was officially prohibited in Europe. Smokers were threatened with the Inquisition or execution. This heathen herb, it was argued, was not meant to be used by Christians.

The first medical warnings were expressed by the Dutch around 1590: Tobacco blackens the brain. Since that time the effects of smoking have been thoroughly studied. Indeed, it may be said that hardly any other drug has been so thoroughly studied as tobacco: According to Estler (3) the health risks of the constituents of tobacco are based on a complex chemical assault with several hundred substances, including hydrocarbons, hydrogen cyanide, ammonia, alcohols, aldehydes, esters and oxides of nitrogen, not to speak of the acids, nicotine and nicotine derivatives contained in the particle phase.

The CO content of mainstream cigar smoke is 6%, that of cigarette smoke 4 % and that of pipe smoke around 2%. After a day's consumption of 20 cigarettes, around 5% COHb is found in the blood. This can lead to polyglobuly in the smoker, with increased erythrocytes and decreased plasma volume. In the short term, carbon monoxide saturation can reach levels up to 1/4 of the blood, leading to a chronic O2 debt and resultant constant cerebral and cardiac hypoxia. Parallel to this the heart rate is accelerated (sympathetic tonus).

The irritants contained in the smoke lead to smoker's bronchitis with loss of the ciliated epithelium. The mortality from chronic bronchitis and its sequelae is 20 times higher among smokers than among non-smokers (resp. insufficiency, decompensated cor pulmonale). Local mucosal irritation leads to reduction of olfactory and taste capacity.

Along with the polonium, phenols, vanadium and selenium, the tar contained in tobacco smoke appears to be the chief causative factor in bronchial carcinoma. It is a proven fact that among smokers the rate of squamous cell carcinoma of the mucosa of the respiratory tract is 11 times higher in the bronchi and lungs and 5 times higher in the larynx and oral cavity. The rates of carcinomas of the esophagus, stomach, pancreas, kidneys, prostate and urinary bladder are 1-2 times higher.

The Alkaloid Nicotine

In 1560 Jean Nicot de Villemain, the French ambassador to Portugal, first became acquainted with tobacco and forthwith made a gift of seeds and a plant to Catherine de' Medici. Soon the "herbe de l’ambassadeur" (note the mercurial element in the name itself) was being cultivated in Paris. It was under this name that Carl Linnaeus introduced it into botany. In 1828 two students of chemistry and medicine in Heidelberg, Karl Ludwig Reimann and Christian Wilhelm Posselt, first succeeded in isolating the main active substance of tobacco and gave it the name of nicotine.

Pharmacokinetics

The alkaloid nicotine enters the body from mainstream inhalation through the oral cavity and the alveoli. By pulmonary resorption—bypassing the liver—it quickly reaches its receptors in the heart and brain. Its elimination takes place oxidatively, largely through the liver. The elimination half-life is 2 hours.

• Low concentrations stimulate cholinergic and adrenergic ganglia. Higher concentrations paralyze them.

• The smoke of one cigarette leads to an approx. 50% rise in noradrenaline and a 15% rise in adrenaline.

• A release of vasopressin from the posterior pituitary occurs. This increases gastrointestinal motility and decreases appetite. By causing adrenaline secretion from the adrenal medulla, nicotine also increases the concentration of cholesterol, free fatty acids and glucose.

• The lethal dose is approx. 50 mg.

• Prolonged smoking causes damage to the cardiocirculatory system:

• At 20 cigarettes/day, CHD with the risk of a lethal myocardial infarction is 3 times more likely.

• Smoking can cause manifest decompression of the heart. Decreased myocardial blood supply, atrial flutter, bundle branch block images and ventricular flutter are also described.

• Peripheral blood vessels are permanently damaged (thrombangiitis obliterans), leading in many cases to amputation.

• The risk of stomach and intestinal ulcers is increased. Amblyopia is possible as a result of primary degeneration of the retina and the optic nerve.

• Pregnant women who smoke are subject to higher rates of premature birth and deformity as well as increased perinatal infant mortality. The most recent reports indicate that children of smokers are more aggressive.

• Body weight is diminished due to increased sympathetic tonus and associated glycogenolysis and lipolysis, which may reach the point of cachexia. Premature aging.

• To this day, smoking remains a highly potent and widespread tool for self-injury.

• "Apart from automobile exhaust, there is probably no toxic product of civilization to which human beings subject themselves and others so copiously, in full consciousness of its potential consequences" (4).

Botany

Within a few months of planting the tiny tobacco seeds, the grower will see his seedlings develop into large-leaved plants that can reach the height of his head or higher. Like tomatoes, tobacco prefers a muck-base medium such as manure.

Nicotiana tabacum is among the annual herbaceous plants of the tropics and subtropics. Its leaves are particularly striking: Up to a meter long, entire and stemless (being attached directly to the stalk), they lend the plant a dignified appearance.

There are 60 species in the Nicotiana genus of the Solanacea (nightshade) family. In cultivation, Nicotiana rustica ("wild" or "Indian" tobacco) and Nicotiana tabacum (a hybrid derived from Nicotiana sylvestris and Nicotiana tomentosiformis) are used. Nicotiana rustica tended to be used more in North America, Nicotiana tabacum in South America and the Caribbean. At harvest time either the leaves or the whole stalk are taken. The leaves are then dried until yellow.

From an esthetic point of view Nicotiana tabacum might be described as stately: The leaf series unfolds rhythmically and is crowned by an un-cramped blossom rather untypical of the nightshades. As Pelikan aptly puts it, "the entrance of the blossoming impulse has not led to any deformation in the rhythmic system."

Astral impulses permeate the entire plant, however. A powerfully aromatic, resinous odor is given off by the leaves and stalk. The alkaloid develops in the root during the growth phase only and migrates from there into the leaves. Nicotine is a fluid and quite volatile substance much like an etheric oil in nature. It continuously evaporates subtly into the atmosphere. "The tobacco sphere" is to be found both in the plant (emanating from the root) and_perhaps even more strongly_around it (in the leaf realm) as a "vapor sphere."

Medical Use of Tobacco in History

In Europe, the news that Nicotiana tabacum had medical uses as a remedy in wound healing and headaches was spread by Jean Nicot Sieur de Villemain (1530-1600).

Jean Liébault (1535-1596) had already described tobacco as a curative plant par excellence for various skin ailments, goiter formation, broken limbs, redness of the face, headaches, stomach complaints and ulcers, poisonous bites, worms, bruises, syphilis and dropsy. Liébault was also the first to point to its specific anticatarrhal action in the lungs, expelling the "flegmatic humour."

It was Nicolás Monardes of Seville who first made tobacco truly famous as a medicinal plant. He was also the first to advocate its use as an enema. Beyond the uses mentioned above, he recommended it for constipation, colics of the uterus, tooth aches and kidney pains. Monardes employed a tobacco syrup for asthma and stubborn coughs, which he attributed to a "cold humour."

From this time on tobacco long remained a panacea, conquering first Portugal, Spain and France, then central Europe. Matthiolus praises its virtues: "The juice, prepared as a syrup / is good for old cough / constriction of the chest / and such ailments / as come from cold, mucous humours."

In 16th and 17th century continental herbals it is praised as "Indian henbane" or "Indian comfrey." Up to the end of the 19th century it remained a highly prized curative for ailments of all kinds.

Tobacco in Homeopathy

Since its remedy proving appeared in Hartlaub and Trinks, the homeopathic use of tobacco has been confined chiefly to acute symptoms:

• Symptoms of collapse, e.g. after smoking the first cigarette in childhood. Desire to keep abdomen uncovered. Cold sweaty hands. Feeling of acute sickness.

• Nausea, deathly pallor, icy cold, perspiration, intermittent pulse, collapse, total exhaustion.

• Seasickness. Utter physical misery and dejection.

• Fear of imminent death. Dulled thinking. Dizziness on opening the eyes. Clearing the throat, morning cough. Persistent nausea. Vomiting of pregnancy.

• Cholera-like symptoms. In addition, effects in chronic illnesses are known:

• Angina pectoris. Paralysis following stroke. Shuffling gait.

• Migraine, Menière's disease, cerebral sclerosis, vascular spasms. Angina pectoris. Dead fingers. Chest cough. Nervous deafness. Amaurosis. Central scotoma.

Each of these symptoms bears a relation—often expressed in the name itself—to death or deathlike processes (fear of imminent death, dead fingers, deathlike appearance, and sterbenselend.1 In homeopathic therapy Tabacum is generally applied in cases with acute symptoms (collapse). Its use in "chronic diseases" is less familiar.

Tobacco in Anthroposophical Medicine

Simonis emphasizes that the alkaloid nicotine destroys the qualities of smell and taste in the human being, thus restricting sensory perceptions. It causes an acceleration of heart rate (sympathetic tonus) without a parallel increase in respiratory frequency. Thus it literally tears the human being apart inside. In a weakened rhythmic system the lungs and heart become dissociated, and thus too the nerve-sense system and the metabolic-limb system. The smoker lives in a state of constant oxygen debt, which leads on the soul level to persistent anxiety. (Angst and anxiety are etymologically derived from a root meaning "narrow" > narrowing of the blood vessels). Rudolf Steiner (5) attributes nicotine addiction to a lack of interest in the life of the spirit. Only the sense organs are stimulated, not the blood system. Practical applications of tobacco by Rudolf Steiner in anthroposophical medicine are reported by Hilma Walter in her three books (6 – 8). These show how highly he valued it for practical treatment purposes, as almost 10% of the cases described in them receive therapy with tobacco (in most cases combined with other remedies). It was administered variously as an enema or a compress and in various homeopathic potencies. The reasons for the different forms of administration, however, are not (yet) completely clear to me personally.

Case Examples from Hilma Walter.

The seven chief metals (6)

• Hilma Walter: Case 110: Hydronephrosis 40-year-old female patient, Nicotiana retention enema during pause in medication, trauma from skating accident?

• Case 62: Puerperal fever in young woman: Nicotiana externally for compress?

• Case 75: 10-year-old girl, congenital stiffening of the joints, baths with Nicotiana etc.

• Case 119: Clinical picture unknown, retention enemas

• Case 151: 44-year-old male patient, tobacco smoke retention enemas etc. for appendix complaints: "Astral body and I not engaging properly in metabolism."

• Case 157: Middle-aged patient, tobacco smoke retention enemas for tachycardia

• Case 86: Bronchial asthma in 30-year-old male patient following military exercises with gas, episodes at 3-4 o’clock a.m.; alleviation after Nicotiana injections (asthma injections with Nicotiana, Prunus spinosa and Gencydo)

• Case 147: Female patient aged 50, external application of Nicotiana 3% and many other medications externally and internally for diabetes and menopausal complaints

• Case 146: Cryptorchism and intestinal parasites in 5-year-old boy: Nicotiana 5% externally on abdomen and groin etc.

Case examples from Hilma Walter. Abnormalities in psycho-spiritual development (7)

• Case 31: Abnormal 14-year old asthmatic boy, injections of Nicotiana etc.

• Case 64: 30 year-old man, depressive disposition, tobacco D2 internally to combat remaining malaria • Case 24: 4-year old girl, pavor nocturnus, tobacco enemas etc.

• Case 90: Menopause, states of anxiety, sensitivity to cigarette smoke, tobacco enemas etc.

Case Example from Hilma Walter.

Plant remedies (8)

• Case 4: Eye injury, injection of Nicotiana and Amanita muscaria (fly agaric) D6

• Case 5: Tobacco injections alternating with fly agaric

• Case 31: 21-year old female patient with struma, malaria; tobacco D30 injections, etc., to prevent malaria relapses, "for highly excited astral body"

• Case 89: Female teacher, 33 years old, cardio-circulatory lability, sleep disorders, tobacco D10 injections etc., left-tending vertigo, abnormal perspiration and irregular pulse. Heavy cold.

• Case 107: Uterine polyp with increased monthly bleeding, Nicotiana D10 etc.

• Case 123: 4 patients with spondylitis following trauma, investigate if lung may not have too little room, shrinking process in one area, enlargement in another. "We have a substance that is exceptionally suited to equalizing traumas. It is tobacco. Injected in a thin dose it proves to be that which equalizes deformities. In order to free the remedy for its full efficacy, phosphorus must be used. In this manner one is sure to obtain healing processes if the patient is under the age of 28. However it should not be impossible, particularly in women, to obtain healing processes even at higher ages."

• Case 124: 47-year old male patient with excruciating foot pain following amputation, relapse on the other foot. "It is quite possible that the whole case is due to a deformation being present at some point in the intestine; it may be that he got a sliver of shrapnel, fell from his horse and took a bump, and that an intestinal deformation was the result. - ... tobacco enemas." "The effect of tobacco smoke on the organism is not at all similar when it is used as an injection or as an enema. You need only one half percent enemas when you use these. Altogether it is a completely different effect that it has on the organism."

• Case 125: Woman, migraine, constipation, stomach complaints, Nicotiana juice injected into nose and vagina.

• Case 126: 38 years old, gastric and respiratory complaints, depleted condition, utterly broken I-organization, tobacco D10 injections in repeated series of 7 injections, etc., fasting cure.

•Case 127: 38-year old woman, impaired ability to function at work, kyphoscoliosis, gibbus, dysmenorrhea and constipation, "ether body deformation and hereditary syphilis tobacco D15 injections"

• Case 128: Nerve concretions following operation tobacco 0.0000001 injections, etc.., as an annual cure

• Case 129: Young lady, 31 yrs. old, disseminated choroiditis, corneal spots, head aches, father and two siblings died of tuberculosis, tobacco D10 injections

•Case 131: Student, 28 years old, lung tuberculosis, pneumothorax; Nicotiana injections

• Case 132: Old rheumatic ailment in 51-year-old woman, abdominal compresses with tobacco and pepper, etc.

•Case 134: Elderly female patient, heart complaints, lower back pain, Nicotiana---enemas every other day, Nicotiana D5 injections 1x weekly

• Case 135: 2-year-old child, bowlegs, Nicotiana D15 every 3 days internally and Hypophysis D6 1x/week

• Case 136: Predisposition to mediumship: high potency tobacco injections in a sense organ

• Case 143: 24-year old female, bronchial asthma, tobacco injections

• Case 36: Stuttering Nicotiana D3

• Case 58: 73-year old woman, vascular calcification in the liver/intestinal region, tobacco enemas, Nicotiana D2 internally

• Case 71: 49-year old young lady, constipation, exhaustion, tobacco D10 injections, tobacco retention enemas

What is notable is the frequent use of tobacco for ailments of the "middle region": asthma, gibbus (thoracic spine), cardiac complaints, pneumothorax and Rudolf Steiner's detailed indication that Tabacum is a very good remedy for the sequelae of traumas (at least 8 case examples) and deformations caused by them (extending even to the bone).

The fundamental lesson of the many case descriptions in Hilma Walter is that Tabacum represents a significant "polychrest" and is probably greatly underprescribed. For this reason, in order to promote understanding of it and encourage its use, up-to-date case reports from our clinic are presented below.

Case Examples

Case 1: Hypoxic Brain Damage

• Mrs. S., E., 62 yrs., was in inpatient treatment in April 2000 with the following diagnoses: 1. Sequelae of prolonged respirator use and 8 resuscitations in condition of exacerbated cold with suspected hypoxic brain damage

2. Sequelae of tracheotomy, sequelae of percutaneous endoscopic gastrostomy

3. Cor pulmonale

4. Sequelae of pseudomonas sepsis

5. Sequelae of nicotine abuse

6. Sequelae of hemorrhagic erosive esophagitis

7. Suspected depressive syndrome

• At time of admission Mrs. S. was in severely reduced overall and nutritive condition. She was immobile and lacked any temporal or local orientation. Almost total bedriddenness and mental confusion. Treatment consisted of Nicotiana tabacum D6, 5 globuli 3 x daily.

• Under this treatment slow and steady improvement was noted. Mrs. S. soon learned to take in sufficient food and fluid independently. The PEG probe could be removed. Her body weight rose from 54.5 to 55.7 kg.

• Mrs. S. is now able to walk surely and independently on her hospital floor using a walking stick. She is able to climb a set a stairs to the next floor.

• She finds the way back to her room alone. She is also able to tell the correct date. Deficiencies in ability to concentrate and notice things are still in evidence, but these are negligible in comparison to her condition upon admission.

• The Barthel Index improved from 20 to 70 points (100 points = complete independence).

Discussion: In this case, the administration of tobacco resulted in excellent recovery in a patient who had required total care. The leading symptoms were the "oxygen debt" (hypoxia) and the "nearness to death" frequently seen with tobacco, as well as the familiar nicotine abuse and the weakness of heart and lungs resulting from it.

The keywords "hypoxia" and "death" should always be taken as indicators of tobacco!

Case 2: Lung Cancer

• Mr. R., 72-yrs., was in our treatment in 10/00 with the following diagnoses:

1. Sequelae of pneumectomy (left) performed on 09/06/00 due to centrally located squamous cell carcinoma of the left lung (histologically poorly differentiated squamous cell carcinoma with extensive necroses and lymphangic carcinosis with spread to small and large pulmonary arterial branches and lymph node metastases (G3, pT2, M0)

2. Postoperative vocal fold paresis (left)

3. Duodenal ulcer

4. Sequelae of soor esophagitis

5. CHD with comp. global insufficiency

6. Sequelae of anteroseptal infarction

7. Arterial hypertension

8. Peripheral arterial occlusive disease

9. Hypercholesterinemia

10. Latent hyperthyroidism

• The pneumectomy was performed on Mr. R. due to his pronounced findings. Postoperative vocal fold paresis (left). Development of seropneumothorax, but this was in regression. Due to advanced stage of illness radio- and chemotherapy were not employed.

• Until time of operation, nicotine abuse had continued at rate of approx. 20 cigarettes/day for over 50 years. Patient is known to have had a lung and costal pleural inflammation.

At time of admission here 73-year-old Mr. R., with an athletic body, was found to be in limited overall condition. Nutritional condition good. His weight was 78 kg and his height approx. 175 cm. Weight loss of 10 kg in preceding weeks. Stress dyspnea. Very unstable gait.

• Postoperative hoarseness / vocal fold paresis

• Decision was made to proceed with mistletoe treatment using Iscador U c. Hg. Series O and regular doses of Tabacum D12.

• Mr. R. displayed increasing progress under this regime. His condition permitted him to walk almost 500 m without pause in spite of parallel reduction of his cortisone dosage.
The vocal fold paresis was in regression and the hoarseness markedly improved. Weight gain of 2 kg.

• Post treatment observation: Inquiry on 02/01showed further stabilization of his overall condition and nutritive condition. He is now able to walk about 5 km with his grandchildren. The dyspnea is gone!

Discussion: In this case we find almost all the known toxic effects of tobacco united in a single individual. Certainly an essential element was the application of mistletoe therapy.

• At the same time, parallel use of Tabacum made alleviation of the complaints possible and accelerated it.

• Squamous cell carcinoma of the respiratory tract calls for parallel use of Tabacum!

Case 3: Global Insufficiency

• Patient Mrs. C. was under our treatment from August to October 2000 with the following diagnoses:

1. Global respiratory insufficiency and congestion-related injury to the liver along with decompensated right-sided heart insufficiency in context of COPD

2. Diabetes beginning 8/00, steroid-induced

3. Nicotine abuse (sequelae of)

• Mrs. C. was brought to the emergency room with dyspnea, chest pains, weakness and edema of the legs. Dehydration. Hypotonia. She was placed under intravenous infusion therapy and long-term treatment with cortisone but was not expected to live long. Contrary to expectations, her overall condition and dyspnea improved.

Development of diabetes mellitus under the cortisone therapy with values up to 500mg/dl.

• On admission to our practice, 66-yr.-old Mrs. C. was obviously prematurely aged, with overall condition and nutritive condition both very poor. Cachexia. Lack of appetite. Rest dyspnea. Moist cough. Sputum, too weak to cough up. Barely able to get herself from bed to chair.

• Marked weight loss in recent weeks. Abdomen soft, distended.

• Mrs. C. received homeopathic therapy with daily doses of Tabacum D30 5-0-0 and Lobelia D6 5-5-5 in order to improve the pulmonary symptoms. Amara Drops (WELEDA) were given to stimulate appetite and alleviate stomach pain.

• With all these measures Mrs. C. was able to make a marked improvement. She is now able to breathe more freely and has become more mobile. Her strength has grown and her weight has increased by 1kg. Edema of the lower legs has disappeared. Parallel to this, the high dosage of cortisone has been gradually reduced from 10mg to 2.5 mg/day.

• The DM was in regression and could be diatetically kept at blood sugar values of 80 – 130 mg/dl in the daily profile.

• Pulmonary condition has stabilized very well. Increased shortness of breath is now noticed only in foggy weather. Patient is now able to take short walks. Improved strength now also measurable in ergometer training.

• As an overall result, from a most serious initial condition it was possible bring about steady improvement in performance while simultaneously reducing medication. Observations from follow-up visit by patient on 07/17/2001:

• Patient's condition remains quite stable. Her elegant demeanor and good appearance made her hardly recognizable.

Discussion: As in Case 2 we see here multiple typical results of tobacco use. The experienced "proximity of death" also speaks for its administration.

Case 4: Stroke and Myocardial Infarction

• Patient Mr. R., 68 yrs., was in our in-patient treatment from August to October 2000 with the following diagnoses:

1. Sequelae of resuscitation with ventrical fibrillation for acute myocardial infarction (posterior and anterior walls) with intubation and breathing support 6/00

2. Sequelae of double stroke with total right hemiparesis

3. Arterial hypertension

4. Diabetes mellitus type 2 b

5. Hyperlipidemia

6. Aspiration pneumonia with positive MRSA

7. Sequelae of insertion of tracheostomy tube 06/22/00

• Upon admission, following resuscitation Mr. R.'s enzymatic indices and EKG demonstrated a myocardial infarction in the anterior and posterior wall region. Repeated attempts to waken the patient produced no result, hence tracheostomy on 06/21/00. For pneumonia (suspected aspiration) patient was treated with Piperacillin/Combaclan.

Tracheal secretion tested positive for MRSA (methicillin- resistant staphylococcus aureus) on 06/29/00. On resumption of spontaneous respiration the tracheal cannula was retained only for bronchial toilet and later completely removed. After 07/00 patient was more alert and attempted to eat (strained food) on his own.

• On admission Mr. R. was still bedridden with no mobilization undertaken. Right hemiparesis with spasticity of right arm, brisk right-sided reflexes with a positive Babinski on the right side. Atrophic musculature, tracheostoma still open, long term catheter.

• At this time his temporal and local orientation were only partial, the overall impression he made was flaccid and apathetic and he hardly spoke. He required help in all tasks of daily life. Lab results showed marked elevation of creatinine and uric acid.

• Therapy with Tabacum D30, Magnesium-phosphoricum D6 and Strophantus D6 (sequelae of myocardial infarction).

• Mr. R. has been increasingly able to be mobilized. He has shown progress both in terms of the myocardial infarction as well as the year-old symptoms of the stroke. With the help of two people he is able to walk around 80m., moving his leg forward without help 3 – 4 times.

• In the mobilization of his arm and hand the first self-motivated activities have been observed (after 1 year!).

• In language therapy the patient is able to compose words out of letters, name objects and assign characteristics correctly.

• Overall however patient's ability to concentrate remains variable. Generally he is in an oriented state, but repeatedly situations arise in which he appears utterly helpless or overwhelmed by sudden thoughts or feelings.

• Unfortunately after removal of long-term catheter the patient was unable to maintain continence.

Discussion: Yet another very difficult case, in which the severest consequences of the old stroke are now combined with those of the myocardial infarction. This is tantamount to a "tearing apart" of the upper and lower human being (from the stroke) followed by a "tearing apart" of the heart.

• Although Tabacum is no longer capable of healing here, even at this stage it can markedly alleviate the symptoms.

Case 5: Encephalitis and Suicide

• Mrs. B., 41 yrs., treatment in December 2000. She was diagnosed as follows:

Primary diagnoses:

1. Sequelae of encephalitis from herpes virus (herpes simplex type II)

2. Sequelae of EBV [Epstein-Barr virus] infection

Secondary diagnoses:

- Vegetative dysregulation

- Secondary amenorrhea (since the encephalitis)

- Tachycardia

- Nausea

- Vomiting

- Fatigue

• Mrs. B. was taken acutely ill during a vacation trip. She initially developed a fever > 39°C. This was accompanied by head aches, nausea, vomiting and state of collapse. Transferred to a neurological clinic, she displayed pronounced meningismus, became somnolent, mentally incoherent and at times only partially oriented and was later partially amnestic in regard to initial events. After two weeks’ treatment in the intensive care unit she could be admitted to the general ward, where she became progressively reoriented and mobilized. Pathological liquor findings; following positive results for herpes simplex II in the liquor, patient received highly dosed parenteral Acyclovir. MRI also clearly revealed continuing presence of encephalitic foci, which were in part slightly regressive and in need of surveillance. Inception of treatment in our practice.

• Mrs. B. had been healthy all her life. In 6/98 her spouse took his life (pat. found him and daughter hanging from a rope in the kitchen). From this time on patient experienced continual nausea in the upper gastric area (according to Rudolf Steiner the place where we are connected with the dead). On the soul-spiritual level, however, she reported being affected surprisingly little by the suicide, finding herself unable to cry much and rarely dreaming of him.

• On admission the patient is completely mobile but complains that her forces have left her. Neurological signs: Biceps tendon reflex and patellar tendon reflex brisk on both sides; achilles tendon reflex can be elicited only weakly. Negative Babinski. Finger-nose test and knee hook test go well. Standing on one leg is shaky.

• Mental finding: Completely oriented in regard to all qualities.

• On admission the patient was still in obviously weakened state. She was subject to repeated nausea and vomiting.

• After the first 2 weeks, in which she showed little improvement, Mrs. B. received a single injection of Tabacum D30 s.c. in the upper abdomen. From this moment on the patient showed steady recovery. She began to feel better and grow stronger as days passed. Initially she had scarcely been able to walk to the cafeteria without experiencing weakness due to circulatory system.

• Paroxysmal tachycardia attacks (also confirmed in extended EKG), palpitations and gastrointestinal complaints, loss of appetite and nausea all have gradually ceased.

• Patient is increasingly able to take long walks or hikes (3 hours). The secondary amenorrhea that set in following the encephalitis has been eliminated. After receiving the single dose of Tabacum, she was able to remove her wedding ring for the first time.

Discussion: In this case of a quite young female patient, the death of her husband was a significant cause of the illness. "The (astral) atmosphere of the deceased" was active around and perhaps also within her.

• Patient received a traumatic shock in the solar plexus region from experiencing the death of her husband, and she (as well as he?) was unable to release it on the level of consciousness.

Case 6: Cardiac Cachexia

• Mr. G., 71 yrs., came under our in-patient treatment in July 2001 with the following diagnoses: Primary diagnoses:

- Compensated renal insufficiency,

- Liver insufficiency,

- Cachexia with unclear underlying pathology.

Secondary diagnoses:

- CHD (coronary heart disease) with 3-vessel disease

- Absolute arrhythmia with atrial fibrillation

- PAOD (peripheral arterial occlusive disease)

- Abdominal aortic aneurysm in anamnesis

- Bronchial asthma

• Mr. G. has suffered since at least 1997 from persistent lack of appetite and aversion to food. These complaints began after a trip within Germany. At that time he experienced shivering and fever up to 42°. He reports having suffered from a persistent tendency to vomit when belching or coughing ever since then. Significant weight loss of approx. 20 kg in recent years.

• Patient reports that repeated examinations, tests and prolonged (months-long) stays in a range of specialized clinics yielded no improvement whatever; rather, if anything his overall condition has gotten even worse. No correlating psychological event is known. He describes himself as feeling good on the psychological level.

• At his last clinic stay in 2/01 the diagnosis of a coronary 3-vessel disease and suspected cardiac cachexia (EF 20 %) was made. He has had the bronchial asthma since 1985.

• Almost total refusal of food and drink in preceding days led to bedriddenness and finally made hospitalization necessary.

• Pat. alert, with age-appropriate orientation in cognitive and mnestic functions, vacillating mood.

• Very poor overall condition in context of cachectic nutritive condition. Pronounced cortisone-induced skin condition. Generalized muscular atrophy. Bedridden. Markedly reduced strength on both sides. Stress dyspnea. Peripheral pulse quite weak to palpation on both sides.

• Mr. G. would hardly eat or drink. He had urinary incontinence. His lower left leg was slightly hyperthermic and sensitive to touch, hampering walking due to intense pain when putting weight on it.

• Therapy chosen consisted of China D6 5-5-5 and Tabacum D12 5-0-0 daily to stimulate the metabolism and eliminate the cardiac weakness.

• After only 2 days Mr. G. was able to leave his bed, at first using a wheel chair. He began to wash himself without help and ate with increasing appetite.

• In rehabilitation Mr. G. learned to walk, at first with a rollator, then unaided.

• Mr. G. experienced a psychological blow one week into his stay, when he learned of his son’s suicide.

• In large measure his psychological symptoms appear to have been marked by (unspoken) tensions in relation to his son. Thus it was to be expected that he would be set back in working towards his own healing by this event. In fact, however, the opposite occurred. Mr. G. continued to gain strength and weight (5 kg!).

• This progress was made despite the fact that at the same time his total medication was reduced and the cortisone treatment gradually brought to an end. No pulmonal or cardiac problems appeared at any point.

• On the other hand a definite renal insufficiency became evident in lab results, but this gradually cleared up considerably. (Creatinine down from 5 to 2.7 mg/dl).

• Overall, starting with a cachexia of unclear origin that had been left untreated for 4 years, under our watch it proved possible to bring Mr. G. into very good overall condition and nutritive condition. Now, after 20 years, he can enjoy his afternoon "Kaffee und Kuchen" again.

Discussion: This patient had been diagnosed with serious cachexia of unclear etiology and of many years’ standing. It became clear only in the course of treatment that his complaints were of psychosomatic nature in large measure, connected with tensions relating to his son. This issue, however, had remained on a subconscious level and was never dealt with consciously. Nevertheless it was possible to achieve significant improvement even before the suicide of his son.

Case 7: Chronic Neurogenic Muscle Disease with Epilepsy

• Mr. W., 56 yrs., was in inpatient treatment with us from June to August 2001. The following diagnoses were made:

Primary diagnoses:

- Chronic neurogenic muscular atrophy

- Polyneuropathy

- Sequelae of skull/brain trauma with ...

- Intracerebral bleeding (right-sided) and - Right-sided skull roof fracture due to a ...

- Fall in 03/01

- Cerebral seizure disorder

Secondary diagnoses:

- (Sequelae of) alcoholism (patient now dry for 24 years),

- Sequelae of nicotine abuse (ending 10 years ago)

- Depressive syndrome

- (Sequelae of 2 suicide attempts in late 1970s)

- Cachexia

• At the beginning of the year 2001 Mr. W. was subject to very frequent falling, to the point where he was hardly able to get up. In 3/2001 he took another severe fall, suffering a skull/brain trauma (intracerebral bleeding and subdural hematoma) with hemiparetic symptoms. Mr. W. was treated in a regional clinic during 5 - 6/2001.

• In inpatient treatment the seizure disorder slowly improved. With a change in medication the frequency of seizures decreased from 15 to 7 times per month. On the other hand his walking ability continued to decline. In the end he was forced to use a wheelchair and developed incontinence.

• The tale of Mr. W.’s sufferings ultimately begins before birth. The child of an alcoholic mother and an abusive father, he was unwanted before his birth. His mother had had at least 2 abortions.

• His seizure disorder began at the age of 3. He turned to alcohol himself at an early age. Towards the end of the 1970s he twice attempted to take his own life using a rope and sleeping pills. A conversion experience in 1980 enabled him to make a radical break with alcohol and he has remained dry ever since. He receives support from a Free Christian community

• Due to the continuing seizures he became unable to work and left the butcher’s trade. In a series of seizures during the last few years he suffered multiple broken ribs and a broken upper arm. • Venereal disease: Patient had been through a gonorrheal infection.

• At admission we found Mr. W. in cachectic nutritive condition with a leptosomatic body build. Poor overall condition. Weight down from 62 kg to 40 kg at a height of 174 cm. Loss of muscle strength. Even sitting required great effort. Trunk stability absent. Markedly atrophic musculature. Contractures with decreased extension in left elbow and left hip. Complains of intense pains and cramps in thigh of left leg, especially at night. Muscle stretch reflex increased on both sides, right>left. Babinski left positive. Tremor. Tendency to incontinence.

• Mr. W.’s cognitive faculties were clearly reduced. Speech very blurred and nasal. Dyslexia. Tendency to confabulation and verbosity. Severe depression scoring 10 points on the GDS. No indication of acute risk of suicide.

• In the initial neurological examination by our neurologist, Mr. W. appeared to have declined further from the first findings on admission: He was alert and cooperative, but was oriented only to person. Double vision, dysmetria. Dysdiadochokinesis. Scapula alata. Tremor in both legs. Blurred speech.

• Patient was diagnosed with a cerebral organic psychic syndrome alongside of suspected amyotrophic lateral sclerosis (Lou Gehrig’s disease), and gradual cessation of Rivotril was recommended. From our side Mr. W. received complementary homeopathic treatment with Arnica D6 and Tabacum D30. In this way his high medication intake could be reduced alongside of considerable stabilization in his nutritive and overall condition at the same time. 

• The (nocturnal) pains in the upper legs ceased following administration of Mercurius solubilis D12. Patient was able to gain 4 kg in weight. His strength level rose steadily. Ultimately he was completely independent in carrying out everyday tasks and could walk approx. 2 km and climb 30 steps without trouble.

• His mental progress was also quite gratifying. Now he appears in a much more ordered state of mind; his attitude seems almost cheerful and alert. The seizures have disappeared!

• At the last neurological check Mr. W.'s condition appeared markedly improved. No more pathological reflexes. No tremor. The neurologist scarcely recognized him as the same person.

• Overall the outcome of this course of treatment must be called excellent. Mr. W. has become practically independent while on extremely reduced medication. He is free of the seizures that had persisted through his entire lifee He to this point, as well as from the chronic hip pain.

• The only thing preventing his living on his own is his naive and uncritical mental state.

Discussion: This case presents us with an almost complete "deformation" of the personality that had persisted throughout the patient's life.

• Indicators calling for the use of Tabacum were the suicide attempts, the emaciation and the traumatic birth circumstances.

• The simultaneous use of Arnica D6 surely also had a very positive effect, as Arnica in low potency is frequently indicated for alcoholics.

Follow-up observation: As of January 1 Mr. W. had had only 1 epileptic seizure (3 days after moving house) and since then has been in very good condition. Continuing appreciable gain in strength.

Case 8: Severe COPD

• Mr. H., born 1937, was in inpatient treatment with us in January 2002. The following diagnoses were made:

Primary diagnoses:

1. Sequelae of pneumonia (9/18)

2. Resp. insufficiency in context of severe COPD (chronic obstructive pulmonal disease) Secondary diagnoses:

- Sequelae of cardiac infarction (enzymatic confirmation)

- Long-term breathing support (sequelae of) with tracheostoma

- Nicotine abuse

• With his COPD, in recent years Mr. H. has suffered from a steady reduction in respiratory performance. Pronounced emphysematous thorax. Has required oxygen since approx. 1995.

• On 01/11 patient collapsed in his apartment (global insufficiency) and required emergency tracheotomy. (He later reported feeling as though he had "jammed a screwdriver down his throat while falling asleep."). In the intensive care unit he suffered a heart attack (enzymatically confirmed). Long-term breathing support. Gradual stabilization following extubation. Healing of stoma. Continued breathing support with nasal probe at 2L/min.

• Among other preexisting conditions, patient suffered from sequelae of injury from a glass splinter and sequelae of nicotine abuse at around 1 pack/day.

• Results of physical examination revealed a 64-year-old patient in limited overall condition and leptosomatic habitus. Weight loss of 16 kg within 2 months down to present weight of 66 kg. Grayish complexion. Palmar erythema. Able to walk slowly without aid in room, but only with oxygen probe. Classic "pink puffer" type.

• Lungs with emphysematous aspect in weakened overall condition and hyperresonant percussion.

• Psychologically patient was oriented to place and time to a limited degree. Reactive depression. • Medicinal treatment: prednisolone reduced to 5mg while continuing current heart medication.

• From the 2nd day on, patient's respiration improved in response to complementary homeopathic medication with Tabacum D12. He reported feeling a sense of "inner liberation" with each dose, as if he were being "freed from chains on the chest" (this from a one-time "chain smoker").

• For the first time in almost 7 years, patient was able to turn off his O2 apparatus intermittently for a few hours, and after 2 weeks he himself made the decision to do without it altogether. At the same time his walking ability increased steadily. At no time was lip cyanosis observed (which amazed the patient, as this always had occurred as soon as he was separated from the apparatus even for minutes.

• After approx. 1 week patient complained of intense bloating symptoms in upper abdomen. With administration of Cuprum metallicum D6 these gradually disappeared. Alongside of Tabacum, in order to further his progress the patient was given two other drugs that have shown good results in this disease picture: Lauroceraus D6 (to promote full respiration) and also, towards the end, Kalium ferrocyanatum D30 (a prime symptom in the drug picture of Kalium ferrocyanatum is a feeling of "choking inside").

• When discharged after 4 weeks, Mr. H. had clearly stabilized. His rest dyspnea was gone and ability to withstand stress had increased. He is now able to climb steps again. Further improvement can be counted on.

Discussion: Once one has developed an eye for the picture of nicotine abuse, one quickly and regularly discovers classic examples. One is repeatedly astonished at the sure success of this therapy (specifically among smokers), even in cases that are just at the point of lung transplantation! The development of upper abdominal symptoms is noteworthy. One has the following impression: – As soon as the astral body is freed from the pulmonary area where it has been "stuck," – it slowly moves back through the gastro-intestinal tract to its proper place in the kidney region.

• This observation is supported by the experience of G. Suchantke. Among successfully treated asthma patients he reports frequently observing spasmodic upper abdominal complaints. In other words they must also overcome this stage in the abdominal area before proper re-engagement in the renal area_a vital seat of the astral body from which it is easily "shocked out" (9).

Diagnostic view of the relationship among the “bodies”

In all of the cases detailed here, we note a mild to pronounced "cramping" ("getting stuck") of the astral body centered in the lung region. Such deformations can penetrate even to the bone realm (gibbus formation). Thus a hyperformation that is characteristic of head pole attacks the rhythmic system. The thorax becomes a second head (emphysema) while the rhythmic system suffers a loss of independence (cf. "hypoxic brain damage"). Hence it is not surprising that parallel to the physical and physiological symptoms, the nearness of death is acutely experienced on the psychological level and can practically always be observed (the nerve-sense pole is the death pole of the body).

Hardly any other remedy is such a powerful vehicle of a nerve-sense death-process that penetrates too low (DD Coca). Another indication for it is after severe traumas, i.e. whenever astral body is no longer able to unite properly with the kidneys and is then forced to "puff itself up" in other organs (the lungs in particular)."

Conclusion

From the beginning, Nicotiana tabacum has been connected with the discovery of America; in fact one can practically call it the "poison" of America ("go West"), or the "nightshade (read: shadow side) of America" (cf. also its use as a substitute currency after World War II). In cases of increasing "westernization" of lifestyle (and illness "style") it is of great benefit.

It is always a sound choice in cases where "death (sclerotic) processes" dominate an individual due to deficient "breathing" in the widest sense_i.e., where a weak rhythmic system becomes overly formed by the head-pole (a gibbus is an example of an incipient misplaced head-forming process affecting the rhythmic system). Simplifying Steiner's image and applying it to the physiological level, one can say that matter—the physical body—is not "spiritually interested." Not being permeated by breath, it suffers from oxygen "debt."

As a rule, Tabacum patients are "materialists," and when they begin to age (if not sooner) they actually become physical images of materialism, manifesting pronounced hardening processes (e.g. cerebral sclerosis). On the other hand Tabacum is a remedy of choice in all cases where traumatic events cause the I-organization and astral body to "spasm" and get stuck in specific organ regions (e.g. the solar plexus and lungs) and is unable to give form to the body, thus possibly leading to physical deformities or to "hypoxic brain injuries." (The astral body, the "god of the wind" whose function is permeating with breath, can no longer properly reach the ether body, the fluid body, the "rain god.")

In skull/brain traumas its highly beneficial action is seen especially in the mnestic functions.

The examples detailed above have demonstrated that the use of Tabacum in homeopathic potencies can bring about significant improvement, even complete healing, in cases of severest "deformity" affecting particularly the rhythmic system.

Very often good to excellent results are observed precisely in those patients who smoke or once smoked themselves. As a rule, these patients seek or sought the spirit in too physical a way (smoke as a symbol of the spirit). No differences among potencies have been found to date. Tabacum D6, D12 and D30 are all used in our practice and they appear to be equally effective. This is an aspect that requires careful further study.

In an article very much worth reading (perhaps the best article on the subject to date), Suchantke expressed praise of Nicotiana in the treatment of bronchial asthma (10). His article can be read as complementary to the results presented here and can deepen the points we have made.

To summarize, the practical applications of Tabacum are as follows:

1. A significant remedy for hypoxic brain injury
2. One of the most important remedies in treating bronchial asthma
3. An excellent remedy for stroke in smokers
4. Cerebral sclerosis and dementia
5. A good remedy after heart attack in combination with Mag-phos and Strophantus
6. Very good efficacy in COPD and emphysema
7. Good efficacy in PAOD (peripheral arterial occlusive disease)
8. For cachectic conditions
9. Raynaud's disease
10. Suicide (smoking = "suicide on the installment plan")
11. Collapse
12. Sequelae of breathing support
13. Very likely a valuable remedy in pediatrics for removing the negative effects of parent's smoking on their infants and children, as well as in adolescence for Scheuermann's disease (juvenile disc disorder) (Disci cum Nicotiana)
14. For patients whose spiritual-physical constitution has been "loosened" by culture shock (e.g., by a visit to India) and find themselves troubled by all manner of "spirits," it may be tried as an injection in high potency (DD Olibanum).

Literature
1
Wolters B. Drogen Pfeilgift und Indianermedizin. Greiffenberg 1994
2 Schmidtbauer W‚ vom Scheidt J. Handbuch der
Rauschdrogen. VerlagFrankfurt 1989
3 Estler C-J. Lehrbuch der allgemeinen und systematischen
Pharmakologie und Toxikologie. Verlag Stuttgart 1990
4 Schmidtbauer W‚ vom Scheidt J. Handbuch der
Rauschdrogen. VerlagFrankfurt 1989
5 Steiner R. Quoted in: Simonis WC. Heilpflanzen und Mysterienpflanzen, Wiesbaden 1983 Seitenangabe
6 Walter H. Die sieben Hauptmetalle. Verlag Arlesheim 1999
7 Walter H. Abnormitäten der geistig-seelischen Entwicklung
in ihren Krankheitserscheinungen und deren Behandlungsmöglichkeiten. Verlag Arlesheim 1987
8 Walter H. Die Pflanzenwelt. Verlag Arlesheim 1971
9 Simonis WC. Heilpflanzen und Mysterienpflanzen. Verlag
Wiesbaden 1983
10 Suchantke G. Ergebnisse und Erfahrungen in der Behandlung des Asthma bronchiale. Beiblätter der Zeitschrift NATURA, Februar/März 1933, Nachdruck Dornach 2000
11 Ibid.

Johannes Wilkens

Alexander-von-Humboldt-Klinik

Dr.-Gebhardt-Steuer-Straße 24

95138 Bad Steben

1 in utter misery (literally "deathly wretched")—translator.





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