Example case: tendinitis calcarea

A 46-year-old woman has been suffering from acute pain in the left shoulder for the last two days. There is local extreme sensitivity to touch and pressure, and she can scarcely move the arm. There is also numbness in the ring and little fingers of the left hand. The pain prevents her sleeping and she is now unfit for work. On examination the front of the left shoulder is warm and swollen, and the motion of the joint is restricted and very painful. Due to the symptoms we suspect tendinitis calcarea, i.e. inflammation in the area of the supraspinatus tendon, which frequently causes calcification in the surrounding tissues. We take an x-ray.

With the checklist of reliable symptoms (Tools) we list the patient’s polar symptoms:

< Touch (P)

< Pressure (P)

> Cold (P)

< Wrapping up warmly (P)

< Physical exercise (P)

< Lifting the limb (P)

< Sitting (P)

Since the polar symptoms (P) are the most important indicators to the required remedy, we only use these for repertorisation.

The patient symptoms are between the blue and red lines: all grades within the green oval are arguments for the remedy. The opposite poles are listed below the red line: all grades within the red oval are arguments against the remedy. The difference between the two sums (21-6=15), also called the polarity difference, shows the specificity of the coverage of the patient’s symptoms. Ledum has an outstanding polarity difference and is therefore the most likely remedy for this patient.

In Hering’s Guiding Symptoms we find for Ledum the following symptoms: Severe stitch in shoulder when raising arm. Painful pressure in left or both shoulder joints < from motion. Limbs numb and fall asleep. Tense, hard swelling of affected joints; painful, hard nodes and calcareous concretions (!). 

Many of these sensations and findings were not included in the repertorisation. In any case the polar symptoms lead directly to the optimal remedy. It is especially astonishing in this case that Hering also mentions calcification.

The patient is given a dose of Ledum 200 C. The following night she sleeps deeply. The next day the pain intensifies again. Ledum 500 C and M ameliorate the symptoms for 10 days each. Since the effect of individual doses is too short, we switch to a daily dose of Ledum Q3 (Q3=LM3). After four weeks the improvement is 80%. With further Q-potencies of Ledum over a period of six months the patient becomes completely symptom-free and we take another X-ray.