Eczema, also known as allergic or atopic dermatitis, is one of the most frequently presenting conditions in a homeopathic practice. The eczema often dates back to infancy or childhood, the child having inherited an allergic predisposition from the parents. In my experience, this eczema is often triggered by introducing cow's milk, or formula containing cow's milk, too early (prior to one year of age). Eczema is most often treated, even in infants, with cortisone cream. The result generally is a persistence of the eczema, ranging from mild to severe, well into adulthood. The suppression, depending on the individual's constitution, may also lead to asthma or other deeper conditions. The following is precisely such a case.
Jeannie, age 25, came in September of 1991 due to severe eczema (3). A thin woman with short brown hair, she was very attractive, with refined, delicate features. She had a degree in art history, but she had been working as a waitress for the previous two years. Her eczema was on the side of her fingers (2) and occasionally her palms. She also suffered from eczema in the bends of the elbows (1) and in the axillae. Her eczema was worse in the fall (2). Jeannie experienced terrible itching (3) from the eczema, worse at night in bed (2) or if her hands were dry (2) and much better from hot water (3). She sometimes developed cracks on the tips of her fingers (1). She would scratch the eczema until it bled (3) and became infected. There was no exudate unless she scratched. She was using Triam cream at the time.
Her eczema dated back to infancy. It had been present for as long as she could remember. In the second or third grade her eczema was so bad that she could not open or close her hands. She also had many rashes as a child. She had warts on her hands around age 12.
Jeannie had sensitive skin in general and she was getting facial rashes. Her fingernails were thick (2), ridged (2), and cracked (2), worse the past six to 12 months, and painful when the nail first grew in. The nails would split (2) and bleed (3). The nail problems began five years earlier. Her medical doctor had prescribed an antifungal cream which made the nails worse.
She had few problems other than the eczema. Her eyes became very itchy when she was around cats and dogs. She had conjunctivitis twice. She had recurrent hay fever at the beginning of each summer with sneezing, runny nose, and watery eyes. There were cracks in the comers of her mouth (1). She experienced indigestion from rich foods (2). Hemorrhoids appeared that year, for the first time. Her joints cracked (1) and she had a "double-jointed" right hip. She experienced some pain in the great toe and ball of both feet (1) after standing all day waitressing.
Jeannie had taken birth control pills for the previous nine years. They made her nauseous the first day of her period, the nausea often leading to vomiting. She had good sexual energy. When asked about sexually transmitted diseases, she acknowledged that she had Chlamydia at age 16.
Although Jeannie liked her job, she was embarrassed to be doing something she felt was so menial. She feared that others were talking about her (2) or would be upset with her (2). She worried about "the little things," like not doing the laundry. She was one credit away from a B.A. when she dropped out of college three years ago. It took a lot for her to stand up for herself. She felt she "was not worth it." She was critical of herself. She had just married and she worried, wondering if she could give her future children what they wanted. Jeannie had always been very sensitive, inside as well as out.
She was chilly (2). She slept on the fight side. She liked chicken (2), cheese (2), vegetables (2), and spicy (2), and she was averse to fruit (1). She was not very thirsty. She smoked half a pack of cigarettes per day.
When I asked Jeannie about motion sickness, she responded that she became hot and nauseous riding in buses and cars unless she was the driver.
The rubrics which I found to be most useful in this case were: "Extremities, CRACKED skin, Joints"; "Extremities, CRACKED SKIN"; "Extremities, THICK, nails, finger"; "Extremities, ERUPTION, Hand, eczema"; "Extremities, ERUPTION, Hand, itching"; "Skin, ITCHING, scratch, until it bleeds, must"; and "Stomach, NAUSEA, riding in a carnage or on cars, while."
My differential diagnosis was between Graphites and Petroleum. Because of the tendency to cracking of the skin, especially on the hands, fingers, and fingertips along with the thickening of the nails and motion sickness, I prescribed Petroleum. Boericke also describes a person needing Petroleum as "sensitive." Jeannie lacked the ulceration and cracking inside the nose and diarrhea of Petroleum, but the symptoms that she did have seemed to fit the remedy clearly. What I (and Jeannie) learned the hard way was that this was one of those cases in which I not only needed to give the fight remedy, but also the right potency.
I prescribed Petroleum 200c. Four days later Jeannie called to say her eczema had been much worse, but was starting to improve. I thought this sounded like an aggravation followed by an amelioration. Petroleum was appearing to be correct.
It just so happened that a few weeks later I attended a homeopathy seminar on Maul where Nancy Herrick, P.A. presented a case of a child with eczema who was cured with Petroleum. "Never," Nancy warned, "begin a case like this with a high potency of Petroleum because you can get a terrible aggravation." Having just prescribed Petroleum 200c for Jeannie, this admonition definitely caught my attention. They were prophetic words.
I returned from Hawaii to find a message from Jeannie. Now, three weeks after the Petroleum, her eczema was bad again, very bad. She tried using Vaseline for the itching. Nothing worked. She could not go to work. I felt terrible. But, Jeannie, although she was new to homeopathy, was willing to stick it out so she could get rid of her eczema once and for all.
I saw Jeannie again five weeks after her initial visit. The eczema was still bad, and now covered her face and hands. It was actually much worse than when she first came in. Now I felt even worse. There was a yellowish discharge from the eczema. Jeannie had drunk half a cup of coffee by accident. Her nails were growing in normally. She had discontinued the birth control pills and had not yet had a period.
At this point, it seemed to me that Petroleum was correct but had been given too high. I also again wondered about Graphites. I decided at this point to give a single dose of Petroleum 6c. I realized that I could have waited here, but I did not know if the remedy was antidoted by the coffee and felt that Jeannie was still suffering.
When I saw Jeannie five weeks later, her itching was much better. I was greatly relieved, as was she. She still had some eczema on the dorsum of her hands, but no exudate. The eczema was still somewhat worse than when she originally came in, at which time it was not at its worst. She still awoke at night itching and she would soothe her hands by putting them in cold water. (Previously the itching was ameliorated by hot water.) When her hands got worse after the Petroleum, cracks appeared around her mouth for one day. Each episode of eczema was less severe, even though it was still the fall, her usual time of aggravation. Her joints still cracked. The pain in her feet was gone. She had nice nails for the first time in her life. They were not thick. I felt that Petroleum was correct and I waited.
I did not see Jeannie again until the middle of March, five months after the dose of Petroleum 6c. She had been doing well, but had recently had a bad flare-up of the eczema, which was already starting to improve again. She had been drinking one latté a day for the previous three weeks. Her eczema was 50% better than when she first came in. She no longer had it on her arms or face, and she no longer developed cracks in her skin. The cracks in the comers of the mouth were gone. She still had occasional motion sickness. Jeannie had quit smoking two months earlier. She had not had a menstrual period in six months, since discontinuing the birth control pill. She planned to try to get pregnant in four or five months. I advised Jeannie to stop drinking the coffee and I did not give her a remedy. I asked her to call me if the eczema was still worse, in which case I would give her another dose of Petroleum 6c. She did not need to call and she continues to do well.
This is a clear and interesting picture of Petroleum, but it also illustrates how careful we sometimes need to be about prescribing a high-potency remedy in a case of suppressed eczema, particularly in a sensitive person. It is true that in a case of a suppressed skin eruption, the person must experience the eruption again, as part of the healing process. However, the degree to which the aggravation occurs depends in great part on the potency of the remedy which is given. Next time I definitely will not forget Nancy's advice!
International Foundation for Homeopathy.
By Judyth Reichenberg-Ullman