Vol. 20 No. 3 June 2000

by Bruce Barwell

A strange thing in homœopathy is how often prescribers say that in their experience such-and-such a medicine cures almost all cases of a certain complaint, but it is not so when others try it.

One good example of this is nocturnal enuresis (bedwetting). The great homœopath Georg Heinrich Gottleib Jahr (1800-1875) wrote in his book Forty Years Practice:
“Sulphur is undoubtedly the remedy that has proved the most speedy and effective in my hands, no matter whether children had a light or dark complexion, were well-fed or thin, neglected, pale, red or had had the itch suppressed or not. Hence, unless some other remedy is plainly indicated by the presence of definite accessory ailments, I always first resort to Sulph, giving two or three doses within a period of eight days, which I allow to act for a long time.

If this remedy is of no avail I give in the case of young girls Sepia, Bell or Puls; and in the case of little boys principally Caust, and in the case of small and fat children, Calc; by this means I have so far succeeded, even in the absence of all symptomatic indications, in curing every case of nocturnal enuresis.

If distinct indications are present, I give in the case of scrofulous individuals principally Bell, Sulph or Calc; if worm symptoms are distinctly present, Cina. Again, if wetting the bed occurs during the first part of the night, Sepia or Caust; and if children wet themselves involuntarily day and night, Bell.”

In more recent times the Bangali homœopath Primal Banerji also wrote about his great success, with a limited range of remedies, in the treatment of bedwetters.

Dr Banerji is noted for having many clinics under his direction employing a rather simplistic style of homœopathy, based on the strategy of giving the remedy known to have been the most successful in many cases, and if this fails moving on the second medicine on the popularity list, etc, based on statistics he has kept.

This is what he said in his book Clinical Research:
“Below are the symptoms by which a drug can be selected differentially from the other which will have precisely uncommon and characteristic symptoms for each of them. This will be suitable for a prescriber to select at a shorter item with correctness.

The drugs in the hierarchy are Medorrhinum 200c, Sepia 200c, Kreosotum 200c, Cina 200c, Calcarea carbonica 200c, 1M, Benzoic acid 30c.

The chief differential symptoms are given against each drug which will work as a pointer preferring one drug over another.

Urine passed out in large quantity in the bed is the chief character of Medorrhinum 200, which symptom is seldom responding to other remedies. Here the urine may be high coloured having sometimes a strong smell. But a very significant symptom supporting this drug is the large quantity, and generally, it is during the latter part of the night or early in the morning which aggravates by cold. Medorrhinum 200 is repeated at intervals of three days. When urination is more frequent like every day then the effects are more when repeated on every alternate day.

The characteristic feature preferring Sepia 200 is occurrence of nocturnal enuresis as soon as the child goes to sleep. Enuresis is repeated within two or three hours as another character of another constitution of Sepia. Nocturnal enuresis of boys with masturbation habit is often an indication for Sepia 200. Sepia is used every fourth day.

Patients often complain of dreaming that they are passing urine in a decent place or urinal and wake up finding them¬selves committing enuresis in the bed; this peculiar symptom calls for Kreosotum 200, generally at intervals of two days. Enuresis at first sleep is with the Kreosotum 200 and another special character is that the child sleeps so fastly that after enuresis it becomes difficult to wake him up. If a case is cured with a single dose or the occurrence of enuresis is rare like weekly or once a fortnight, in those cases the second dose is given after the next occurrence and thence onwards repeated once a week if required.

The familiarly known characteristic symptom of intestinal worms when associated with enuresis prefers Cina 200, where the child is often found with a ravenous appetite though it is not a compulsory symptom. It prefers a repetition every third day, suits the dose in the evening and requires continuation for a month and thereafter every week or at least once a month for permanent result.

The older boys and girls even at marriageable age remain very difficult cases for even an experienced homœopath. Though the scope of selecting above mentioned drugs as per their respective specific symptom remains open and should be tried as the first preference, still in such grown up cases often they fail probably because of the alteration of the constitution developing through years by the age. The exhaustive clinical trials have ultimately surmounted the difficulty and it has been concluded that Calcarea carbonica 200 or in very old cases, 1M, when repeated at intervals of three or four days may be continued for two or three months could be successful. Though it has been recommended that a flabby constitution is a better indicator of this drug, still we have observed that it has got successful results without this special feature in most of the cases.

In most of the Materia Medicas simple words that nocturnal enuresis has been listed under Benzoic acid. But during our research trials it has been concluded that the very pungent and offensive smelling urine is the only guideline for preferring Benzoic acid in its 30th potency to yield fast results, and this may be repeated at intervals of two days if not checked by the first dose.

There are some peculiar symptoms which prefer Belladonna 30 as “urine passes during sleep in daytime”. In another constitution of Belladonna 30 nocturnal enuresis occurs “with profuse perspiration”.

Can these two distinguished and experienced homœopaths have their prescribing ideas improved upon?

In the British Homœopathic Journal of October 1994 the Mexican homœopath Jorge Cortina reported on what he held to be a great success in the treatment of bedwetting with a group of 20 children who as well as bedwetting were obstinate, introverted, had restless sleep and nightmares. Ten children had their problems disappear, and these had a change for the better in behaviour too; two had a relapse after initial success half-way through the treatment; and eight remained unchanged in both the mental and physical sphere.

Dr Cortina gave Ilex paraguayensis 6x for a month, then 6c for a fortnight. The remedy was given in pilules an hour before meals. He writes:
“Twenty child patients suffering from nocturnal enuresis were investigated, 12 male (60%) and 8 female (40%). The frequency of enuresis varied from daily to once a week, with an average of four times a week. Children displaying enuresis with infections, mechanical obstructions or malformations were excluded from the trial.

Nine of the males (75%) were circumcised, 12 (60%) were single children in whom the predominant factor was over¬protectiveness on the part of their parents.

The 8 remaining children (40%) were members of families of 2 or more children who displayed mistrust and rebellion towards their parents or resented their parents’ favouritism for another child. In 10 patients (50%) the complaint appeared during deep sleep. This is based on the observation of the parents and other relatives who reported that the patients did not wake up in spite of loud noises. Two (10%) displayed the habit of masturbating. On the other hand 10 patients (50%) had problems of diction – speech delay, stuttering, echolalia or dyslexia. One child manifested somnambulism. All of these symptoms were considered to be part of an emotionally affected personality.

With reference to their social environment, some children presented conflicts between parents and children. Other children belonged to families where the parents were suffering from alcoholism or were highly addicted to tobacco.

Ten (50%) were children of divorced or separated parents. All the children (100%) were walking and of school age, ranging from 4-8 years with an average age of 6 years. Fifty percent attended nursery school and the others various grades of primary education. Six (30%) of the youngsters had been treated by psychologists without favourable results, while another 4 (20%) had received specific conventional medical treatment and 10 (50%) presented for homœopathic treatment as their initial plan. One child had an ultrasound of the urinary tract and 1 an intravenous urogram to exclude con¬genital malformation.

The patients attended on four occasions: every two weeks for two months.

The fundamental parameter for the success of the treatment was obviously the disappearing of bedwetting as well as improvement in behaviour. On the other hand an attempt was made to influence conflicts between parents and children favourably.”

What is Ilex paraguayensis, or more accurately Ilex paraguariensis? It is made from the leaves of a tree in the holly family that can grow as high as 7m, but it is often cultivated and kept to pickable height. It is grown in Paraguay, Uruguay, Argentina and Brazil because maté tea made from its leaves is a popular drink there. It is available in health food shops in New Zealand.

Why did it work on Cortina’s subjects? Perhaps it worked like a stimulant, preventing deep sleep; perhaps it worked as a sedative/ tranquilliser, allowing a more natural depth of sleep when the child’s anxieties were relieved.

Perhaps it could be a medicine for attention deficit disorder, a condition which puzzles conventional pharmacologists and doctors because ADD children are calmed and have better concentration after having medicines containing strong stimulants like caffeine and amphetamines. Ritalin is a quasi-amphetamine which is a speed-up for non-ADD people.

Maté leaves contain caffeine; tea made from them has 25 to 150mg of it per 8 ounce cup; cocoa has 5mg, green tea 15mg, Ceylon tea 30-70mg, espresso coffee 100mg, instant coffee 30-120mg, percolated coffee 40-170mg, Pepsi 26mg and Coca-Cola 30mg.

Maté tea enthusiasts dispute the caffeine content figures given above. They say it has a minute caffeine content; it would take 100 teabags of maté to equal one cup of coffee, researchers at the Free Hygienic Institute of Hamburg, Germany, are reported as saying.

The maté promoters claim that incorrectly done analysis has confused mateine with caffeine; mateine’s molecules are identical to caffeine’s but are arranged in mirror-image fashion; that is, it is a stereo-isomer of caffeine. Because of this structure it is very unlike caffeine, they say.

Claiming that mateine, like all the xanthines, promotes smooth muscle relaxation, they say it is this action that makes xanthines (with the exception of caffeine, in which smooth muscle relaxant effects are diminished by other side effects) good clinical dilators of the bronchi and hence useful in the treatment of asthma.

Mateine appears, then, to possess the best combination of xanthine properties possible. For example, like other xanthines, it stimulates the central nervous system; but unlike most, it is not habituating or addicting. Likewise, unlike caffeine, it induces better, not worse, attributes of sleep. It is a mild, not a strong diuretic, as are many xanthines. It relaxes peripheral blood vessels, thereby reducing blood pressure, without the strong effects on the medulla oblongata (end part of the brain connecting to the spine) and heart exhibited by some xanthines. We also know that it improves psychomotor performance without the typical xanthine induced depressant aftereffects.

Dr Jose Martin, director of the National Institute of Technology in Paraguay, writes, “New research and better technology have shown that while mateine has a chemical constituency similar to caffeine, the molecular binding is different. Mateine has none of the ill side effects of caffeine.” And Horacio Conesa, professor at the University of Buenos Aires Medical School, states, that there is not a single medical contraindication for ingesting maté. Clinical studies show, in fact, that even individuals with caffeine sensitivities can ingest maté without adverse reactions.

Lincoln Mall Pharmacy has Ilex paraguariensis in 6c, 12c and 30c potencies.

Readers who use the remedy are invited to send Homœopathica reports of successes – or failures.

What are the two remedies I most frequently prescribe with success in bedwetting? Chloralum (chloral hydrate) in 30c, because it stops the very deep sleep common in many sufferers, and Pituitrin, in a variety of potencies, if there are any of its symptoms present – chosen because it may stimulate the production of antidiuretic hormone, proven to be a factor in many cases if present at the wrong level. The orthodox antienuresis drug Minirin (desmopressin), administered by a spray up the nose, works because it is analogous to antidiuretic hormone.