Right in the middle: a case of Sabal serrulata

The patient is a sixteen-year-old lad, tall and lean, with short curly blond hair. He developed psoriasis on his scalp about a year before we first met, when he started high school. Around the same time, he also started to become sleepless: it takes him about two hours to fall asleep at night. This is his main problem and it irritates him.

His mother says that he is very sensitive. He is easily touched by reprimands and he weeps at criticism. Like his grandfather, he is closed, thoughtful, and gallant towards others. Sometimes, his seven-year-old sister makes a mistake and calls him “Daddy". 
He is always indecisive and unsure about decisions. For example, he cannot decide whether to stay with his grandmother for a weekend or not. After making any decision, he starts to doubt himself.
In general, he considers himself patient, but in the past he had fits of anger, which he later regretted.
He feels insecure with new people, wondering if he will be accepted by them. What will these new people think of him, will they consider him sympathetic enough? It is difficult for him to make new relationships and enter new groups.  Still, he is at the very centre of his circle of well-known friends and schoolmates. They say that he is very friendly and reliable, and that they can trust him.

The most important issues for him are his friends and his family.
Fears: high places.
Hobbies: sports, mainly fencing: one needs to be quick and to have a perfect concentration.
He would like to be a movie director. He also likes to work with wood.

Generals
Warm-blooded (6 on the scale of 0 - 10)
Desires: chocolate, fried food
Aversions: sweet food (pancakes, baked yeast dumplings)

Personal history
Since the age of thirteen, he suffers from bronchial asthma, mostly expressed as a dry cough (> wet weather, < dust, < exertion)
Strabismus operation at age nine
Sometimes, pains in knees, wrists, lumbosacral region (stitching, < stooping)
Level of health: 75%

Family history
Mother, brother, sister: hay fever

First prescription: Sulphur 30C

I did not have a clear understanding of what was going on for him or what was his problem. I did not see a clear mental picture, any causative factor or specific story. Although not very happy with my prescription, I gave him the remedy, based on a bunch of quite vague rubrics:
Cough, dust, as from
Cough, exertion, agg.
Generals, weather wet, amel.
Head, eruptions, psoriasis
Fear high places
Sleep, falling, difficult
Irresolution

The desire for chocolate and his warm-bloodedness fitted Sulphur. Against Sulphur, however, was his feeling of insecurity, his irresolution, and his sense of responsibility.

Follow ups
After a month: cough and falling asleep partially improved for three weeks. When he repeated the dose, while still feeling well, he immediately got a very bad headache, cough, and coryza, all this lasting for three days. Then, he felt better again: he could fall asleep in half an hour but was still coughing and sneezing, though he was free of breathing problems during exertion.

Prescription: Sulphur 200C, one dose

After three months: he was ill twice, with a dry cough. He still has headaches and the psoriasis has remained unchanged. Only the sleeplessness has completely gone.  

Analysis
I was not very happy with the progress of the case. It looked like we did not have a precise simillimum; his symptoms persisted and only his sleeplessness was gone. A signal for a partial simile was the aggravation when the remedy was repeated during a phase of improvement. According to Jan Scholten, nothing adverse happens when the precise simillimum is administered during the phase of improvement, but the state deteriorates when a partial simillimum is given in this period. So, I looked at his whole picture again.

My general impression was that he needed a plant remedy, confirmed by his nature: soft, sensitive, weeping, caring, and gentle.

His psoriasis and sleeplessness started when he went to a new school. He is unsure with new people and the most important things for him are his friends and his family. So, the main concern is relations, indicating the Silica series. The idea of this series is also supported by the age when the problems started; he was fifteen. Diseases arising in puberty can be associated with the Silica series, which, in Jan Scholten‘s Plant theory, is related to the Monocots clad 633. The idea of the Monocots is also supported by his nervous quality, easily having tempers, which is typical for teenagers (Silica series). It is worth noting that Sulphur is also in the Silica series.

Then, I did a procedure with him that I now do with nearly every patient when I think a plant remedy is needed: I explained the phases and subphases, and asked him where he would place himself, objectively (seen by other people) and subjectively (where he is or would like to be) in relation to the most important group of people. Without a hesitation, he told me that he is in the middle of his friends and also feels responsible for his family. People see him in the middle and responsible for the group, and he likes to be in the middle of people dear to him. He is there and he wants to be there. So, he confirmed the 4th phase and 4th subphase.

Then, I described the wave of 17 stages. I already thought of the 5th stage, as he is doubtful and questioning decisions he has made, which he independently confirmed.
So, we came to the remedy Sabal serulata – number 633.44.05, in the Plant theory.

The Plant system developed by Jan Scholten is an incredibly valuable map, filling the vast area of until recently unknown mind states of plant remedies, and relating them to mineral remedies. It makes it possible to prescribe any plant remedy, known or unknown, at a constitutional level, not just our well-known polychrests.

I always confirm the remedy found through the Plant system with its known symptoms. Sabal serrulata is a small remedy, with only 276 rubrics (Synthesis Treasure Edition in Radar 10). The following rubrics fit his case:
Irritability
Excitement, nervous
Sensitive
Mental exertion, agg.
Starting, sleep, from
Head, pain, students
Cough, whooping
Back, pain, lumbar region

Not many, but better than nothing! The patient had no problems with bladder and genitalia, which is the biggest part of the known picture of Sabal serrulata. Relying on the Jan's system, I prescribed Sabal serrulata 1M, three doses, at one hour interval.

Follow ups
After two months: several days after the remedy, he realized there was no scale on his scalp, and no headache. He had no pains in his extremities and back. He was falling asleep in 10 - 15 minutes. No cough and no breathing difficulties.

After six months: he feels very well and has no recurrence of his former problems: clear scalp, quickly falling asleep, no cough, no headaches, no pains in the extremities, and he is less insecure with unknown people. 

Photos
Shutterstock; group of friends outside; William Perugini
Wikimedia Commons; Silver saw palmetto; Mmcknight4; public domain