A Case Of Autism With A 20 Year Follow-Up

The following case is formatted according to CARE guidelines (1)

Introduction

Autism is a neurological developmental disability which adversely affects social interaction, communication skills, and cognitive function. Individuals with autism often suffer from numerous co-morbid medical conditions which may include: allergies, asthma, epilepsy, digestive disorders, persistent viral infections, feeding disorders, sensory integration dysfunction, sleeping disorders, etc.(2)

The prevalence of autism is not affected by race, region, or socioeconomic status. Since autism was first diagnosed in the U.S., the incidence has climbed to an alarming one in 68 children and 1 in 42 boys.(2) Currently there is no allopathic cure for autism, though with early intervention and treatment, the diverse symptoms related to autism can be greatly improved. Homeopathic medicine offers a safe and effective treatment for this condition; many children will need a number of homeopathic medicines or different potencies of the same medicine over time. Homeopathic treatment also allows other interventional methods (behavioral therapy, change in diet, etc.) to work more effectively. It has also been the experience of a number of homeopathic practitioners that, in a small number of cases, the correct homeopathic medicine may work rapidly and thoroughly to alleviate this condition. These cases often involve the use of potentized “drug” medicines. The following is one such case.

 

Patient Information

In January 1996, a mother brought her 22 month-old son in to see me. Just two weeks prior, he had been diagnosed autistic by a pediatric neurologist at Columbia University in NYC. The mother was clearly distraught about the diagnosis of her son as she tearfully related the story.

John (not his real name) was born full term, 8 lbs., 3 oz., good Apgars, no complications and was nursed for six months. However, John was ill as an infant with recurrent upper respiratory infections (“mostly colds”) and episodes of wheezing especially at night that were ameliorated with bronchodilators. He was an easy child and his mother described him as very passive—if someone took something away from him like a toy, for example, he did not object.

What was most striking about the child was his dreamy, vacant, disconnected appearance. From the moment he walked into my office, John never once made eye contact with me or even seemed to notice my existence. He had bright beautiful blue eyes that would stare into space as he lay on the floor of my office. Occasionally he would get up and wander around aimlessly then occasionally stop to touch his mother before lying back on the floor and staring into space.

John’s development was slightly delayed; he sat up at 9 months, crawled at 11 months and walked at 14 months. His mother did not recall any reactions from vaccinations. He also had a very limited vocabulary.

The mother stated:

• “John wanders off a lot and I have to keep a close eye on him in public.”
• “He will sit and stare at a spot on the wall for minutes, or endlessly watch TV if we let him.”
• “He is a good sleeper.” (knee-chest position).
• “He loves to be naked and barefoot.”
• “He places everything in his mouth.”
• “His stools tend to be loose.”
• “He stopped babbling months ago and hardly says a word.”

John liked cheese, milk, eggs, veggies, meat, and fruit, though his appetite was not great according to his mother. He used to sweat from his head as a baby and his tolerance to pain was fairly high (mother said he didn’t cry too much after falling).

Family History

Mom reported use of marijuana for many years throughout college and before conceiving the child; she used it occasionally during pregnancy. Rest of family history was unremarkable.

Diagnostic Assessment

Severe case of autism with minimal contact.

Homeopathic Assessment and Treatment

The history of marijuana use by the mother in light of the dreamy, disconnected behavior of her son were the strongest clues in this case. While other remedies came to mind such as Opium and Helleborus, which can also appear in this detached, disengaged manner (Opium also has a high tolerance to pain), the potential for marijuana as a contributing factor in this child’s case was undeniable from a homeopathic and miasmic perspective. (see Discussion below). While I did not repertorize the case at the time because of my confidence in the prescription, I have done so here for educational purposes.

Rubrics

MIND: dream, as in a
MIND: absorbed, buried in thought
EYES: staring
RESPIRATION: asthmatic; night
TALK, Talking; incoherent

Plan: Cannabis Indica 200c, (Quinn, Hahnemann pharmacy), one dry dose.

 Follow-Ups and Outcomes

Mom called my office the next day and I could sense excitement in her voice.

“Dr. Saltzman, it’s a miracle! What did you give John yesterday?”

“Why, what’s happening?”

“You won’t believe this, but I found John standing up in his crib this morning babbling like crazy. I haven’t heard a peep from him in months. And he was actually holding his arms out for me to pick him up. Usually in the morning he just lies in his crib staring at the ceiling. Please can we give him more of that stuff?”

I explained to her that we needed to wait because the remedy would continue acting in his system. Over the next few days to weeks, there was a remarkable acceleration in John’s development and speech. He began making eye contact; in fact, his mom stated that he started going up to people and hugging and kissing them. Within days of the remedy, he would run around the house pointing at objects wanting to know what they were. “It’s like he is making up for lost time,” the mom stated. As his language accelerated, the words couldn’t come fast enough out of his mouth!

I saw John two months later and I was shocked when he came right up to me, looked at me with those bright blue eyes and then hugged me!

Mom stated: “He is less placid; in fact, he gets frustrated more often if he doesn’t get his way and he is more aggressive with his sister.” John was more sociable, showing a real interest in people; he would sometimes go up to strangers and hug them. He was not glued to the TV; in fact, he showed very little interest in watching it at all and spent most of his time exploring the house and playing with his toys.

Plan: Wait.

A phone follow-up eight weeks later revealed that John was now putting words together, although his language was still very much delayed for his age. He had begun asking for things (instead of just pointing). Mom described him as being very observant. “He understands everything now,” she said. He hated getting his haircut and would scream and flail. John was showing real interest in other kids and he was sleeping well. His appetite was still poor and his food choices were  unchanged.

Plan: Wait

I saw John approximately ten months later for a followup. He looked at me inquisitively and then went straight to play with the doll house in my office. He was restless, getting up often to explore the office, touching everything in his view. Mom said he had become very aggressive with other kids, sometimes hitting and kicking them unprovoked. Yet at the same time, he could be extremely affectionate, caring and sensitive, asking others “are you ok?” if he thought they were hurt. He was now toilet trained, defiant with his parents, often hyperactive, and could be destructive with his toys at home. Mom also described him as being somewhat “flirtatious’ with girls. He still slept in the knee-chest position, loved dairy and had limited food choices.

Assessment: At this point I knew that John was ready for a different homeopathic medicine because his aggressive behavior was starting to limit him socially and he was becoming much more difficult to manage at home. The Cannabis indica had obviously awakened this sleeping child by removing the ‘miasmic influence’ of the substance and he was showing signs of more normal constitutional behavior. Tuberculinum covered his restlessness, destructiveness, food cravings and sleep position, but these symptoms, as well as his extremes of behavior, sensitivity, and flirtatiousness in one so young, led me to prescribe Medorrhinum. Also he had a strong sensitivity to reprimand (he would cry if mom scolded him: MIND; Reproaches, ailments from,  aggr.) which I have found to be a defining characteristic of children needing Medorrhinum as compared to those needing Tuberculinum, who will often resist reprimand and become even more obstinate and defiant when reproached.

Plan: Medorrhinum 200c, (Quinn), one dry dose.

At the six week follow-up, John’s mother stated that his aggressiveness was much improved. “He is not going up to children anymore and hitting them,” she said. His behavior was improved at home though he could get easily upset if he didn’t get his way, and his “flirtatiousness” and appetite remained the same.

Plan: Wait.

July 23, 2016

I didn’t hear from John for the next 19 years when he returned to my office at age 22 with a main complaint of severe anxiety for the past 18 months. I recognized him immediately by those brilliant blue eyes. But John was quite unlike the placid sleepy boy I first saw in my office 20 years ago. In fact, he had quite an intense personality. He appeared animated, friendly, loquacious and extroverted. He had just graduated from college with a business degree and was pursuing a career in finance.

He complained of panic attacks in the morning on waking, his “stomach in knots,”sweaty hands, palpitations and hot/cold flashes. He sometimes vomited from the anxiety. The panic attacks started over a year ago when he began making plans to study abroad for a semester and he was placed on Lexipro 20 mg with mild improvement.

He reported having sinus surgery in 2013 for a deviated septum and chronic sinusitis and a tonsillectomy in 2015 for chronic pharyngitis. He became addicted to the pain medications and went through “tremendous withdrawal” when he finally stopped them. He also complained of acid reflux when stressed and he told me that he smoked marijuana in high school and throughout college. He continued to smoke marijuana when he felt “stressed,” but it didn’t do much to calm his anxiety.

John presently had a new girlfriend after a recent break-up, and he said, “I like having a girlfriend; I want the companionship. I’m very sensitive and affectionate.” He admitted to being “more emotionally dependent” and he liked to party but was not a big night person. He described himself as very sociable with lots of friends. He also had a “fear of losing control,” and complained of anticipatory anxiety before exams and job interviews. He was generally hot and preferred salty and spicy to sweets.

Homeopathic Assessment

As I listened to and observed John, there were a number of homeopathic medicines that went through my mind. Phosphorus was evident from his bright beautiful eyes, “effervescent personality,” his strong need for companionship and generalized anxiety. His anticipatory anxiety, intensity and openness reminded me of Argentum nitricum. Aconite covered his panic attacks as well.

However, considering the history, the fact that John continued to use marijuana throughout high school and college, and knowing that Cannabis indica was a common remedy for anxiety and panic attacks, I opened up one of my favorite materia medicas, “Desktop Guide to Keynotes and Confirmatory Symptoms” by Dr. Roger Morrison, and I was struck by the following sentence under Cannabis indica: “Symptoms begin when he travels or moves to a new or foreign place.” John had specifically stated that his panic attacks began 18 months ago when he “considered studying abroad.” Just the thought of traveling abroad triggered tremendous anxiety for him. This completely confirmed the remedy for me.

I also explained to John how important it was for him to stay away from marijuana, not only because it could antidote the homeopathic medicine but because he was too vulnerable to the substance on a deep level as evidenced by his history. I explained that his continual use of the substance might also be causing “proving symptoms” of anxiety and panic attacks. He appeared to understand and he agreed to abstain from its use.

Plan: Cannabis indica 200c (Quinn), one dry dose.

John called four weeks later to say that he felt much better for about two weeks but then “spiraled downward” when he did not get a job he expected. He was continuing to interview in many places. He complained of much anxiety, especially in the morning on waking, felt his “knees buckling,” and described “pins and needles” sensations all over. He told me he had not used marijuana since our last visit.

Plan: Cannabis indica 1M (Quinn), one dry dose.

John called to cancel his one month follow-up appointment because he “felt great.” His panic attacks subsided within a week of the medicine and he was continuing to look for a job in the city. I recently spoke with his mother (about eight months later) as I was preparing this case and she said that he continued to do well and was now working at a job in the city.

Discussion

The homeopathic prescription of Cannabis indica was evident from the child’s symptoms of dreaminess, detachment and disconnectedness. These are symptoms that Cannabis indica caused in healthy people during homeopathy’s drug trials or provings as well as information gleaned from the widespread experimental use of the substance. However the fact that the child responded so deeply and rapidly to the medicine shows how the mother’s use of marijuana might have contributed to a type of miasm (predisposition to disease) in this vulnerable child, the key word being vulnerability. For example, the child’s older sister was healthy though the mother had also used marijuana before and occasionally during that pregnancy as well. Obviously, the son’s constitution was extremely sensitive to the substance in a way that his sister was not. This reveals how uniquely individualized homeopathy is as a system of medicine that addresses both the nature and nurture aspects of disease. The psychosocial (including family history and predispositions to disease) and environmental factors (toxins, vaccines, allopathic medications, etc.) as well as the individual’s temperament (inner strengths and weaknesses) that influence a person’s vulnerability to these external factors all contribute to an individual’s manifestation and expression of disease.

I have treated many autistic children through the years and I have had only one other case that responded so dramatically to a homeopathic medicine. (Most autistic children will show slow steady improvement overtime with either different homeopathic medicines or the same medicine in varying potencies.) It was a six-year-old girl with a diagnosis of pervasive developmental disorder (PDD) who spent the entire time in my office in fantasy play. The mother also appeared to be in denial of the severity of the child’s disconnection from reality. It was the mother’s deep denial in the face of this completely detached child that led me to prescribe Opium 200c which completed transformed this child. Within 24 hours, she experienced severe temper tantrums as waves of anger and grief were released, eventually leading to a completely awake, conscious, and “present” child. Seeing the child’s reaction was frightening for the mother who experienced her own “awakening” as she suddenly recalled memories of physical abuse by her father when she was a little girl. From a homeopathic perspective, we can surmise that the memories and pain of this abuse lay dormant in the mother, who might have passed this onto the child leading to a type of “numbness” and detachment from reality. The emotional pain unleashed in the child by the homeopathic medicine allowed her mother to get in touch with her own pain—a single homeopathic medicine healed both mother and child.

It is interesting that both of these cases involved the use of potentized “drug” remedies. The question for me is whether these children were truly autistic or rather “autistic-like” as a result of a drug’s influence (marijuana in John’s case) or a type of post-traumatic stress disorder (in the girl’s case) that was transferred from mother to fetus and was miraculously alleviated with homeopathic Opium, one of our best medicines for PTSD.

Patient Perspective

“My son was transformed by Dr. Saltzman and I am forever grateful. He had not spoken or used his voice for over six months when we went to see her. He did not make eye contact and avoided interactions. He would watch the same movie or look at one book for hours on end. Dr. Gold at Columbia had just diagnosed him autistic when I took him to see Dr. Saltzman. I was desperate and had no where else to turn. Dr. Saltzman spent two hours with me and my almost 2-year-old son, asking strange questions about his habits. Finally she gave him a remedy and sent us home. The next morning, he woke up babbling. I could not believe my ears. From that moment on he was changed. He is now 23 and embraces the world and loves relationships. He has a job that requires tremendous interpersonal skills, is amazingly outgoing and friendly, and is in love with a beautiful girl. He smiles all the time, has a positive attitude and he has a clear, direct way about him. I am forever and deeply grateful to Dr. Saltzman for altering the course of his life.”

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Susanne Saltzman, MD
Editor, American Journal of Homeopathic Medicine

Article published in the Summer edition of the American Journal of Homeopathic Medicine.

Learn more about the American Journal of Homeopathy

References

1. Gagnier, JJ. et .al ., The CARE guidelines: consensus based clinical case reporting guideline development, BMJ .Case reports 2013; doi: 10.1136/bcr-2013-201554
2. https://www.autismspeaks.org/science/science-news/autismand-health-special-report-autism-speaks