A fourteen year old boy complains of cough and tiredness. He has grown a lot during the past year, both in height and weight, and is now 180cm tall and of a sturdy built. He has been coughing for the past few weeks and it is getting worse. He coughs in fits, which almost make him vomit. He has received Ventolin and Flixotide from his GP, which help. Two years ago, he had whooping cough and was very tired; he just sat on the sofa, fiddling and wriggling. He has had respiratory problems since childhood, with a blocked nose. When he has a fever, he has nosebleeds.
He does not do much of the talking, he leaves this to his mother while he sits and listens in a neutral, not unfriendly manner. His mother tells: “He always on the sofa, lying in a foetus position or with his head in his hands. He drags himself upstairs and finds everything ‘too much’. Despite being so sick and tired, he wants to go to school, saying: “I want to do that test.” He pushes himself but as soon as the most necessary things are done, he collapses. At home, all he does is lounge about. He loves to play rugby and wants to be good at it. He continues to go to school even though he just sits on the sofa like a bag of potatoes, before he leaves for school but he never complains. He chooses to go every time, not just out of routine, and he does not want to have to be pushed. He even goes to school when he is sick: “I’ll go and if I’m not feeling well, I won’t go home. When I’m already at school, I don’t want to come back.”
He does everything with a big sigh: “I’m not feeling well.” He feels worse in the morning and he gets out of bed as though he is made of wood. After playing sport for some time, his attention falters and he becomes quite distracted. He starts again every time.
His mother describes him as follows: “His head is so heavy. He is always supporting his head, no matter where he is.” Sometimes he has headaches that feel like prickles in the top of his head and he also feels a bit dizzy.
He is a quiet, watchful, and very self-sufficient boy. He looks for easy solutions, is very direct, and names things without adjectives; he talks without frills. At home, he has a resigned attitude: “It is too much effort to play up or to resist, I don’t enjoy things but I will do what needs to be done.” He avoids confrontations with his parents; one can see him looking for other solutions but he usually just does what he is asked because complaining costs too much energy. He is very socially minded, has trust in people, and often mediates between people. Sometimes, he can be very angry without really knowing why.
His main complaint is tiredness, similar to a post-mononucleosis picture. He continues to do what he has in mind, even if it is hard for him. He functions well socially and finds his own solutions. He has a sturdy build and an uncomplicated behaviour. These all point to a remedy from the Fabales order, but which one?
His heavy head, described in the literature in the rubric “Head, desire to lean on something”, is typical of the remedy Gymnocladus. Nosebleed with fever is known in Melilotus, which, along with Indigo is also known for spastic cough. A tired head, nosebleeds and uncomplicated behaviour can fit Belladonna, but there are no other characteristics of Solanaceae. The mental tiredness is found in the rubric “Mental work impossible” where the remedies Copaiva, Indigo, Gymnocladus, and Melilotus are named. The desire to lean on something has been cited in the generalities of Gymnocladus by T. Allen.
There is a typical alternation in his pattern. He begins something if it really needs to be done or if it is nice to do, and then becomes completely floored. He tries to accomplish something but at the same time cannot be bothered. He knows what he wants to do but cannot manage it, or he postpones doing it. This pattern has been seen in previous cases of tiredness, which have reacted well to Gymnocladus.
Prescription: Gymnocladus canadensis 200K, one dose
His energy improves, as do his ability for sports and study. His cough disappears, although he still uses Ventolin before rugby games. Three months later he has a relapse; his concentration deteriorates, he is irritable and cannot get going. During tests at school, he feels his belly contracting; “how can I manage?” His parents, who are rather domineering, are angry if he is not doing his best at school and put all his effort into sports. It is, after all, possible for him to achieve something that they have not been able to achieve, if he studies hard (duty versus enjoyment, a Fabaceae theme). He avoids people who are attached to rules and regulations. He eats piles of sandwiches. A repetition of the remedy improves his energy almost immediately. It would seem that being under pressure from the outside world - parents, school, work, or social environment - having to achieve more than one feels capable of, can be causative factors for a Fabaceae indication.
Two years later, after a concussion while playing sports, he has another relapse. He is emotionally out of balance and insecure due to his poor school results. His concentration is good for a while and then disappears, which also happened in childhood. He is physically very restless, sometimes running through the room, and he has a mild stutter (stage 5). The enjoyable things in his life are not there, but the ‘duty’ of school and study remain. The situation is typical for this period of life but he experiences it as “my life is no fun, this is not what I want,” (Fabacaeae) and it brings on more complaints. A repeat of the remedy brings peace again. The next year, after a serious injury stops his sport career, he develops eye problems (accommodation), which are helped by Manganum Phosphoricum. Manganum is an important component of many plants in the Fabales order and it is an important differential diagnosis for this whole group.
Keywords: tiredness, coughs, nosebleed, concentration difficulties
Remedies: Gymnocladus canadensis