A stubborn case of nocturnal enuresis (bed-wetting)

From Dr. Ahmad Fakir Muhammad’s case-files

Mr. A., aged 22, unmarried, tailor, dark complexion, medium height, lean and underweight, slightly anaemic, consulted me on 24-09-1995 for enuresis which had been with him since childhood and for which he had remained under the treatment of 3 or 4 doctors including his brother who is a homoeopath.

His sleep is deep and sound. He dreams of making urine and awakes to know only that it has happened. This happens once or twice a week but now for the past four consecutive nights. At times, remains without the complaint for a month or even more. At times frequency of urine increased – almost every half an hour. After micturition, feels that two or three drops remain in the urethra that come out on straining.

Other symptoms included: vertigo, uneasy sensation in legs and other parts of the body – moves them (legs). Burning in abdomen if does not take meals at normal time. Uneasy feeling and rumbling in abdomen when hungry. Unbearable hunger – eats and gets hungry. Despite voracious eating, weight is below normal. Likes company, is talkative, likes and tolerates cold things – cannot bear heat, dislikes summer – gets easily exhausted.
Iodum 200, two doses, one at bed-time and the other next morning with placebo.

There was slight recurrence after one and a half months but since then, to the best of my knowledge, the patient has remained free from the complaint.

The remedy in this case was easy to spot as a number of key symptoms of Iodum were present in the case.

The above case was placed at the Homoeopathic Bulletin Board, UK, with an invitation to the homoeopaths and other learned members to guess the curative remedy. The response was overwhelming but no one was, sadly, able to work out the right remedy. Selection of Iodum was challenged by a few on the ground that it did not cover the urinary symptoms!

Anyway, I was later asked to justify its selection. It is not always easy to give words to the thought process a prescriber undergoes while taking a case and going over it after it has been taken; all the more so if it is to be done years after the case was cured!

First, let me state, the case in question was not repertorised. Nor do all cases need a thorough repertorial analysis. For a case like this, one can directly go to the Materia Medica for a comparison, if one is doubtful which of the few remedies covering the broad features of the case must be selected.

The patient was predominantly sensitive to heat. He felt worse in summer. He desired cold drinks and tolerated them well. When one sees a patient with such a degree of intolerance of heat, one hardly considers chilly remedies, unless the patient is a child or there are some other equally striking symptoms pointing to a chilly remedy.

The patient was excessively hungry, he could not bear hunger, he ate and got hungry and despite voracious eating was anaemic and underweight. I have found this expression truly guiding in a number of cases. In the repertory, we have it as: ravenous appetite with emaciation. Several remedies have it. Out of these, four seemed relevant to the case: Iodum, Lycopodium, Natrum mur and Sulphur. All the four are warm remedies according to the list of Gibson Miller.

I had seen in the past, how Lycopodium and Sulphur had worked well in a number of cases of nocturnal enuresis. But I could not recall, any of such patients had so striking an aggravation from heat and such a voracious appetite. The question was of degrees and grades. Sulphur, Natrum mur and Lycopodium have both < heat and emaciation despite voracious eating but none has it so intensely and strikingly as seen in the pathogenesis of Iodum.

True, Iodum does not have nocturnal incontinence nor does it have dreams of making urine. On these points, Lyco and Sulph were stronger if only the quantitative aspect of the totality was to be seen. But we never do that.
The patient had received treatment from a well-known homoeopath of Aram Bagh. The patient card showed six visits to the said homoeopath. Except for Sepia and Natrum mur, names of other remedies could not be read. Potency was not mentioned.

So, my choice fell on Iodum and it did not disappoint.

You may also like to read: Homeopathy in bed-wetting