A Case of Autism

The following case was presented at the Seventh Annual Case Conference of the Homeopathic Academy of Naturopathic Physicians in Portland, Oregon on April 17, 1993.

Danny was a four and a half year-old boy with a delicate frame. He was referred by the family practice physician to a psychiatrist who diagnosed him as autistic. His mother brought him to us in hopes of using natural therapies to treat her son.

Danny’s sleep problems started just after his fourth birthday. He woke up at night due to his fear of wind (3) and the noise of cars on highway (3). He awoke with agitation (3) from12:30-1:30 a.m every night (3) and often again at 4:00 or 4:30 a.m.(2) [We noticed that Danny was tensing his mouth periodically in grimace-like gestures.]

Lately noises had started to bother Danny during the daytime. He was scared of the dark (2) because he might run into things. Danny would wake up crying and frightened and would “run madly into his parents’ room”.

He sometimes talked about kids being mean to him at daycare. He took negative reactions from playmates very personally (3). He cried (3) and became upset easily (3). He was especially upset about six months earlier when his father had to shoot a robin that kept flying into one of the windows of their house. [More grimaces]

Danny was an only child. His parents had been married 16 years and had a good relationship. He liked to be around other children. He was generous with others. Danny was a follower and somewhat shy (2). His mother described him as cautious (3). She could put a new food on his plate forever and he might never eat it. Danny checked things out before advancing (3).

Danny’s mother had a normal pregnancy with him. He was born by C-section due to the failure of her cervix to dilate. He weighed 5# 8 oz. at birth. His developmental milestones were normal except tht he was slow learning to talk. By two years three months he’d learned the alphabet and numbers and was beginning to read. He was two years ahead of the other kids at preschool. He had always been very low on the height and weight charts.

Danny talked to himself frequently (2). He repeated to himself what mother says (3). [Counted to himself during the interview]He did this in whispers (2). He was not terribly physically active. Danny’s mother said he was passive (3). Most cartoons were too violent for him (3). He asked, “Why are they hitting each other? I don’t like them.” Danny was very talkative(3). “He could go on and on” according to his mother.

Danny had a history of molluscum contagiousum. In June ’91 started wetting bed occasionally. Was on Imipramine 25 mg q.d. for a while, which helped.

He desired chicken noodle soup (2), peanut butter sandwiches (2), sweets (2), and salty (2). He was averse to fats (2) including butter, mayonnaise, cream sauces, and whole milk. His thirst was normal.

Now, study this case and come up with your remedy prescription. Then turn to page ____ for the case analysis.

The first question for us was whether or not the diagnosis of autism was correct. The diagnostic criteria for autism include abnormal social relationships, a language disorder with impaired understanding and echolalia, rituals and compulsive phenomena and impaired intellectual development. The syndrome, diagnosed by 30 months of age, is characterized by extreme aloneness (failure to cuddle, avoidance of eye contact), rituals, repetitive acts, speech and language disorder (varying from total muteness to delayed onset of speech to marked idiosyncratic use of language), and markedly uneven intellectual performance.

We did find this child to be shy and not overly communicative during his first visit to our office. He had the habit of repeating what his mother said and talked to himself often. His facial grimaces were odd. However, when he spoke to his mother, he verbalized well. In fact, he appeared to be very bright. He was curious about his surroundings. His mother reported that, although he was shy, he did interact appropriately with other children. We did not feel the diagnosis of autism was accurate.

The first two remedies that we thought of for this child were Arsenicum album and Stramonium. We considered Arsenicum because he was slight with dark hair and looked frightened and because he woke at 12:30 to 1:30 a.m. every night and 4:00 to 4:30 a.m. most nights with fear and agitation. He was averse to fat, like Arsenicum, and was very upset about the bird dying. Arsenicum is listed in italics in “Mind; SENSITIVE; to noise”. We thought about Stramonium because of his fearfulness and the grimaces. We wondered if he had a strong fright that his mother didn’t know about, which sometimes creates a Stramonium state. Perhaps his mother’s failure to dilate during labor may have resulted in birth trauma for him. We also considered Silica, again because of Danny’s delicate appearance, his passivity and mild nature, and his disinterest in physical activities. But none of these remedies felt exactly right.

When we looked at the case again, it seemed really clear that the key to Danny’s case was sensitivity to noise. It wasn’t that he was waking with night terrrors or because he was afraid of being alone. It was the sound of the wind or cars on the highway that caused him to wake up. Then he became agitated. He also struck us as being a particularly sensitive child, in fact oversensitive. He was sensitive to noise, to slights, even to new situations.

We felt the remedy forhim should be in the rubric, “Mind; SENSITIVE; to noise”. Aconite. Asarum, Coffea, Silica, Theridion, and Tuberculinum were all bold type in this rubric and, we thought, all possibilities. However, one remedy seemed to fit the best.

We had just returned from the Maui homeopathic seminar where Roger Morrison, MD had presented a case of this remedy. He told us it was a remedy to strongly consider for the combination of insomnia, oversensitivity to noise, and restlessness. This information comes from George Vithoulkas, the Greek master of homeopathy. Allen says of this remedy, “All loud noises make a strong impression…”. Boericke describes it as having a “nervous hyperaesthesia” and as having an affinity for the tubercular diathesis. This child definitely had a tubercular body type. “Great inclination to be startled” was found in many provers of this remedy. All of the materia medicas emphasize the tremendous sensitivity to noise. Boericke: “SENSITIVE TO NOISE; IT PENETRATES THE BODY, ESPECIALLY TEETH. Noises seem to strike on painful spots all over the body.” Farrington says, “At night an imaginative excitement in the head…”

This is the picture of Theridion. Theridion is a small spider which inhabits the West Indies and is frequently found on orange trees. It is interesting to note that both this child and his mother had very strong reactions to bug and spider bites. They would develop large, open sores. We had never given this remedy before but it seemed to fit quite well. What was most interesting to us about this case is how the remedy picture of Theridion became more and more clear as the case developed. This case really helped us to gain a personal feeling for the remedy and that is why we wanted to share it at this conference.

We gave Danny one dose of Theridion 200C. His mother brought him back two and a half months later. He was now less anxious in daytime.

The past ten days he was sleeping most nights. He had slept through the first four nights after taking the remedy. He got a cold a week after remedy at which time he had a Ricola cough drop. He still wakes up wet.

He was now waking more at ease. He was no longer terrified. His mother mentioned that his disposition was quite pleasant. He was more enjoyable to be around, especially the past ten days. Danny was not as anxious. Things didn’t set him off as easily. He still covered his ears on the ferry dock when the fog horn blew (2). He no longer tensed face as much. [We noticed that he was not grimacing as before.] He said good-bye to a guest and to some ladies on the ferry. That was unusua for Danny becuase he didn’t usually talk much to strangers. He no longer seemed as delicate when he bumped into things. He wasn’t talking to himself as much. It seemed to us that the remedy was probably working. We did not give another remedy and asked his mother to call us in one month.

Five weeks later Danny had a cold and a paroxysmal cough (2). Danny had slept through every night though he was having enuresis regularly (3). He was doing very well in daycare and seemed to be standing up for himself more. His noise sensitivity was now isolated to internal combusion engines. We gave him one dose of Silica 30C in hopes of addressing the enuresis and asked his mother to call us in 7-10 days.

At Danny’s next visit one month later, his mother told us he had been perfectly dry for first four nights after remedy. The second day after the remedy mother noticed that he was more cooperative in the morning. He ate some coffee candy a week before the visit. Danny had awakened twice in the night since then like he did before the original remedy. The last few days he was asking questions incessantly (3) His anxiety and sensitivity to noise were still better. He no longer tensed his face, grimaced, or repeated things under his breath. He hadn’t been covering his ears on the ferry dock anymore. Overall his mother felt that he was doing much better than when we started. Her only complaint was the enuresis.

Four days later Danny’s mother called to say that his symptoms were definitely back. We decided that he had antidoted the Theridion with the coffee candy and we gave him another dose of Theridion 200C.

At his visit five weeks later, Danny was sleeping better again.

His enuresis was unchanged. We decided to wait and asked him to come back in three months. We thought the enuresis might remit in time.

We next saw Danny two and a half months later. He had done really well until the past month when he had become sensitive again (2), but nothing like before. His mother elaborated, “I’ve been thinking about the way he reacts. It’s almost as if his senses are attentuated to certain input. The most obvious thing was the hearing.” He was not waking up at night. He’d been complaining about the frequency of noises. He said that even a quiet bell hurt his ear (3). [We noticed that he was grimacing again.]

He hadn’t even wanted to touch a plantain flower because he said it was too spiky. He was really sensitive to pain (3), whether little or big owwies. When someone touched his hair, he screamed (3). It really hurt (3). His scalp was really sensitive(3). Danny was not as agitated. He had drunk a sip of iced coffee earlier in the month.

He was very sensitive to bug bites and spider bites (3). He would develop big, open sores from the bites (3). So did his mother. She recently put Neosporin on some of his bug bites.

Danny was more talkative (2) lately. “His overall state is more sensitive.”(2) He had been argumentative (2) and contrary (2). He desired soup (2) and had jags of being a pickle fan (2). Sometimes Danny complained of his legs being tired (2). He became lethargic (2) and just flopped down wherever he was (2). He was wet only three or four nights this month, which was a vast improvement. We gave Danny Theridion 1M.

He returned three months later. He had been dry half the time or more until two weeks before when he started wetting bed again. The Kindergarten teacher said he was doing fine. Sometimes he said, “Nobody likes me.” Thesleep problems hadn’t returned. There were no noise or ear problems and no facial gestures He was still pretty sensitive to pain (2.) His head was not as sensitive. He no longer complained when hair was brushed. He still desired soup (3) and was averse to cheese (3) and milk (3). Danny complained of being tired at times (2). His legs tended to fall asleep and he stomped to wake them up (2). “I don’t like a wet bed.” He had some episodes of feigned laughter (2) at least once a day. No particular fears. he Slept on his back and abdomen. We thought he was doing well and did not give him another remedy.

Three months later Danny’s mother reported that he was having wet nights again lately. The previous month he was dry over 70% of the time. The previous two weeks he had been a lot more compulsively chatty (3) and was whispering to himself again (3). He was more angry (2). He still was not waking and was not sensitive to noise. He had a habit of plopping himself down like he was really tired (2), even in the grocery store. He would just fall into a heap (2). He was a little more sensitive to pain again lately. He had more of a need for order (2). Danny became agitated when things weren’t a certain way (2). He was whiny (2). “His general demeanor was funky the past two weeks.” He was not pretending to laugh anymore. We repeated the Theridion 1M. He has done well since.

In reviewing Danny’s case, we were reminded that he was very talkative, even though he was shy. Talkativeness is mentioned in a number of materia medicas as characteristic of Theridion. Another quirk about this boy was his forced laugh. Farrington, in The Comparative Materia Medica, refers to the “hilarity” of Theridion. Agrawa, in his Materia Medica of the Human Mind, lists in Theridion rubrics: “Cheerful, gay, happy”, and “mirth, hilarity, liveliness” as well as “excitement in the evening”, “frightened easily”, “hysteria”, “loquacity”, and “restlessness driving him out of bed”. It is interesting to look at this chart, from MacRepertory, of the 25 rubrics in the “Mind” section of the Complete Repertory in whichTheridion is listed in either bold or italics.

The information which came out later in the case that seemed so strikingly characteristic of this remedy was the sensitivity to even a quiet bell ringing, his screaming on having his scalp touched, the almost hysterical quality to his laugh, and the fascinating description by his mother of his finding the plantain leaf to be almost spiky.

In retrospect, we feel that we were too concerned about the enuresis. Danny was improving considerably mentally and emotionally but the mother kept emphasizing the enuresis, which was the only persistent symptom remaining in the case. Clarke (Dictionary of Materia Medica), Hering (Guiding Symptoms), and Phatak’s Materia Medica mention that Theridion has “urine increased” and “has to rise four or five times in night to micturate, does not pass much during day.” It is interesting that the regularity of the enuresis has waxed and waned with the remedy. It is nowhere near as often as it used to be.

According to the point of view of the Vithoulkian essences, this child’s oversensitivity to noise Rajan Sankaran, in The Spirit of Homeopathy, affirms that it is the central disturbance in an individual which has to be cured in diseases, and not the pathology. That, he says, is the secret. This central disturbance, which includes the mind and the neurological, endocrine, and immunological systems will naturally create disturbances in each organ system to a greater or lesser extent, depending on the individual’s susceptibility. we feel that this boy’s enuresis is a manifestation in his urinary system of his oversensitivity and tension, just as the facial grimacing or tensing was a neurologic manifestation.

It will likely recede over time or another remedy will be needed. (Note: Now, two years later, the only symptom of Danny’s which has persisted is enuresis. He has continued to do very well in all other ways and has not needed another remedy.)

A couple of other interesting tidbits about Theridion: People needing Theridion can experience sharp neuralgic pains over the left eye like Spigelia. Farrington also compares the headache of Theridion to that of Bryonia. He once treated a lady sufering from intense headaches and nausea that were worse from the least motion. He gave Bryonia without success. However, when the patient added the fact that noises made both the headaches and nausea worse, he found the simillimum in Theridion.

Farrington also usedTheridion for “the sea-sickness of nervous women who become deathly ill when they shut their eyes to try to stop the motion of the ship.

The last point we want to mention is that Asarum and Silica are said to be in the same family as Theridion. We think it is possible that Danny may need Silica later due to his delicate constitution, refined nature, shyness, sensitivity, and tiring easily. Aranea, Mygale, and Tarentula, all spiders, are similars. The restlessness and hypersensitivity of Theridion is quite similar to that of Tarentula, however the sexual sphere is generally more pronounced in Tarentula and Mygale.

Dr. Judyth Reichenberg-Ullman and Dr. Robert Ullman are licensed naturopathic physicians and are board certified in homeopathy. They are President and Vice President of the International Foundation for Homeopathy where they teach homeopathy to licensed health care professionals. They practice in Edmonds, WA at 131 3rd Ave., N., Edmonds, WA 98020 and can be reached at (206) 774-5599. Their new book, The Patient’s Guide to Homeopathic Medicine, is now available.

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Written by Judyth Reichenberg-Ullman ND MSW

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