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The primary characteristic underlying the Natrum mur. pathology is introversion arising out of a feeling of great vulnerability to emotional injury. Natrum mur. patients are emotionally very sensitive; they experience the emotional pain of others, and feel that any form of rejection,, ridicule, humiliation or grief would be personally intolerable. Consequently, they create a wall of invulnerability, become enclosed in their own worlds, and prefer to maintain control over their circumstances. They avoid being hurt at all costs.

People susceptible to developing the Natrum mur. type of pathology are emotionally sensitive and vulnerable, but quite clear and strong on mental and physical levels. Mentally, they have a high degree of objectivity and awareness, as well as a great sense of responsibility. For this reason, they are likely to be the sympathetic ear to whom others turn when distressed. The emotional sensitivity and the sense of responsibility readily lead such people into fields of counselling, psychotherapy, the ministry etc. While listening sympathetically to someone else's suffering, such people maintain their objectivity and appear to be very strong. They internally absorb the pain of others, however, and they dwell on it later; particularly, they wonder "How would I react in such a situation? Would I be able to take it".

Throughout life, individuals with Natrum mur. tendencies experience deeply all impressions of life, accumulating awareness and understanding beyond their age. They are strong and enjoy being presented with challenging circumstances, even those involving emotional risk. At first, they enjoy company and thrive on the nourishment of emotional contact with others. They enjoy receiving affection from others - indeed, they inwardly expect and demand it, even though they do not themselves express affection easily. They are so sensitive that they feel hurt by the slightest comment or gesture that might imply ridicule or rejection. Natrum mur. adolescents, for example are reluctant to date, for fear of rejection. Even imagined slights can cause suffering. After being hurt several times, they learn to become cautious. They will think twice before becoming involved in an emotional experience. They turn to introverted activities which are emotionally "safe", i.e. reading books (usually romantic fiction or things having practical value in human relations), listening to music, dwelling on ideas and fantasies.

They can become quite content in their isolation. They tend to be self-contained, desiring to solve problems by themselves without trusting help from other people. Gradually, they come to the point of not needing contact with the outside world. If someone intrudes upon their private, introverted world, they may feel resentful. Their primary concern in life becomes, "not to hurt and not to be hurt".

The issue of emotional pain, in themselves or in others, would be the end of the world for them, they are completely incapable of knowingly inflicting pain on others. For this reason, they become very serious. They cannot make jokes that might inadvertently ridicule someone else. They may appear cold and overly objective to others because they are so intent on not revealing their own emotional vulnerability or creating injury to others. This, combined with the Natrum mur. sense of responsibility, results in guilt being a strong motivating factor in the lives of such people.

Physically, children with Natrum mur. tendencies are likely to be thin and delicate. It is common to see a fine, precise horizontal line dividing the lower eyelid in two. This line is commonly seen in young girls with hysterical personalities; other remedies showing this line include Asafoetida, Lilium tig. , and Moschus. In addition, there may be a characteristic crack in the middle of the lower lip.

A Natrum mur. child is very sensitive to disharmony. If the parents fight the child may not react krjnediately but will suffer inside, perhaps even to the point of acquiring a physical ailment.

These children are usually quite well-behaved; it is not necessary to severely discipline them because a mere glance conveying disapproval will suffice.

The hysterical tendency in Natrum mur. children is seen readily when they are severely reprimended. They then react to an extreme degree, falling on the floor in a tantrum, kicking and screaming. Consolation or reassurance are of no avail, and may acutally make them worse; they will continue with the tantrum until they themselves decide to stop.

At an older age, the hysterical tendency shows itself in another way. Ordinarily, Natrum mur. people do not express emotion readily; they do not cry easily, for example, when suffering a grief. They may be quite serious in their demeanour. However, when nervous or under stress, they tend to laugh over serious matters, then to giggle hysterically; as this giggling becomes uncontrollable, it dissolves into hysterical weeping.

Adolescents of this type are likely to be quiet and withdrawn, but with a sense of responsibility and integrity. At a party, they tend to sit on the sidelines, enjoying themselves by watching others and imagining what they are experiencing. If they are attracted to someone, they will not be flirtatious or friendly. Indeed, they may appear to pay no attention at all, only watching the other out of the corner of the eye. They are liable to fantasize that the other person is likewise attracted and they may romantically blow the entire situation out of proportion. This is the reason why Kent states that a young girl who needs Natrum mur. will easily fall in love with a married man, or someone unattainable. This then causes intense anguish and grief, and the result is an even greater introversion.

They develop intense emotional and sentimental attachments for people, but they don't show their feelings. A daughter may have a deep feeling for her father without anyone else realising it. Then the father dies. The daughter grieves silently, locking herself in her room and crying in her pillow. To the surprise of everyone around her who did not realise the depth of her affection, she becomes very introverted, desiring only to be alone with her books and her music. There is no moaning or crying in front of others - merely occasional sighing perhaps. This internal state continues until she finally breaks down. Then there is uncontrolled, hysterical sobbing with massive shaking of the body, spasms, and twitchings. Such an outburst usually lasts just a short time, and she quickly regains control and composure.

The first stage of pathology in Natrum mur. appears on the physical level. There may be gastritis, arthritis, migraine headaches, canker sores, or herpes on the lower lip. As might be expected, such conditions are likely to occur after a period of introversion following a sever grief or humiliation.

Alternatively, the patient may become hysterically reactive to every influence in the environment - overly sensitive to noise, to f light, to cigarette smoke, etc. In such patients, allergies and eczema are common.

Neurological disorders are also very common in Natrum mur. Neuralgias affecting the left eye or the left intercostal nerves, for example, are frequent. Multiple sclerosis often responds to Natrum mur. as well, when the totality of symptoms fits. Heart disease can occur, but it tends to mainfest as arrhythmias and palpitations - which arise from the influence of the nervous system on the heart.

It is during the earliest phases of pathology that some of the most well-known Natrum mur. keynotes are found. The patient lias a strong desire for salt, and an aversion to slimy food and to fat, there is an aversion to chicken as well. Characteristically, there is an intolerance to heat, sensitivity to light, and aggravation (of headaches and skin particularly) from the sun. These are true to varying degrees in all of the Natrums, but they are more or less equally expressed in Natrum mur. The Natrum mur. aggravations from the sun and light are not as marked as they are in Natrum sulph. and its aggravation from the sun is not as marked as in Natrum carb. The Natrum mur. patient may be sensitive to both heat and to cold, though usually more so to heat. It is less sensitive to heat than Natrum sulph., and also less sensitive to cold than Natrum carb.

A characteristic symptom of Natrum mur. is the inability to pass urine or stool in the presence of others. This arises from the fear of ridicule, resulting in a chronic tension of sphincter muscles which can be relaxed only in private.

As the emotional vulnerability becomes increasingly pathological the patient becomes depressed. This is a depression which is inconsolable, and may even become suicidal. Suppose, for example, a young man experiences a severe rejection or grief; he retires to his room and puts on the saddest music he can find. The music is not designed to alleviate the depression, but rather to add to it. He wallows in the depression. If one thing has gone wrong, he exaggerates everything out of all proportion. He allows no-one to help; he tries to solve the problem within himself. Eventually, when the depression begins to pass, he regains a more appropriate perspective on life, and music will at that point relieve the remnants of the depression. It is in this sense that music may be either aggravation or amelioration to Natrum tnur., depending on the circumstances.

This kind of depression is a kind of hysterical reaction. Ordinarily, the Natrum mur. patient is objective as long as control over the emotions is maintained; but when emotional control breaks down, the patient becomes irrational, and the emotional sphere rules everything.

As the pathology moves beyond the phase of depression, the patient begins to experience periodicity of physical symptoms and alternation of moods.

Physical complaints occur at predictable intervals and times. This is why Natrum mur. is often indicated in patients who have suffered from malaria in the past or who have been adversely affected by quinine drugs; it also can be useful in patients in whose family there has been malaria. Migraine attacks often seen in Natrum mur. patients tend to occur at fixed times, usually between 10 a.m. and 3 p.m. Asthmatic attacks, likewise, tend to occur between 5 and 7 p.m.

The moods swing from unreasonable depression to unreasonable exhilaration. As the patient's objectivity becomes interfered with, everything on the emotional level is carried to extremes.

By this stage, some of the characteristic physical symptoms may gradually disappear. As the pathology progresses to deeper levels, there may no longer be desire for salt, aversion to slimy or fatty foods, aggravation from the sun, etc. The disappearance of these traits is directly proportional to the progressive deepening of the pathological state. Often it will be necessary for the homoeopath to inquire into such symptoms not only in the present, but also the past.

As the pathology begins to reach into the emotional level, the first fear that develops in claustrophobia. In early stages, Natrum mur. patients enjoy relative emotional freedom and resent any constrictions imposed by others. Later on, their own vulnerability causes them to close off. When they perceive the same kind of enclosure outside themselves (i.e. closed or narrow places) as they have created within, they become fearful.

Along with the claustrophobia, there occurs a rigidification of the emotional and mental planes. The patient develops fixed ideas; things are seen in terms of good or bad, right or wrong, correct or incorrect, practical or impractical.

Eventually, a hypochondriacal anxiety about health emerges, particularly in regard to heart disease. This hypochondriasis is related to the fastidiousness seen in Natrum mur. The patient is driven by a compulsive need to avoid contamination - always cleaning, washing hands, disinfecting everything. In Natrum mur. fastidi ousness is specificially a fear of microbial contamination, and not so much the feeling of disgust seen in other remedies (Sulph, Puls, Merc, Phos, Mezereum). Also, in Natrum mur. anxiety about health is much less significant than hypochondriasis, which is more of an anxiety - compulsive attention to details about health.

Finally, even the compulsive control mechanisms break down completely, and the person openly expresses everything which previously had been disallowed. They become shameless, exhibitionistic, speak in obscenities, etc. In the final stage, Natrum mur. patients do not usually lose mental control to the point of developing full-blown insanity, but shameless behaviour may occur.

Natrum mur. is such a deep-acting remedy, and it is so commonly indicated in our western world, that there are many other remedies to which it should be compared.

Ignatia, of course, is the closest of all remedies to Natrum mur. In many respects, they are virtually identical. For this reason, they often replace one another in particular cases. Generally, Ignatia acts more superficially and is more likely to be indicated in cases where patients' reactions are more superficial. Natrum mur. patients have greater strength, they can tolerate more emotional stress and more intense shocks without breaking down. In Ignatia, the person breaks down with relatively minor stress. In addition, the Ignatia pathology does not as readily affect the physical level. Thus. Ignatia is more indicated in emotional reactions appearing after ordinary griefs experienced in life, whereas Natrum mur. is more commonly indicated in instances of extraordinary stresses, particularly those causing breakdown on the physical level.

The Ignatia patient frequently feels constricted in the throat or in breathing, especially following an emotional shock. The characteristic Ignatia sighing is an attempt to relieve this sensation of constriction. Ignatia cries more easily and is more likely to cry during the homoeopathic interview than Natrutn mur. Following a grief, the Ignatia patient is less likely to experience sleeplessness than Natrutn mur.

Frequently, particularly when there are mostly physical symptoms, Phosphorus may be difficult to differentiate from Natrum mur. Physically, both look quite similar - thin, sensitive, even perhaps hyperthyroid. The main point of differentiation, of course, is whether the patient has a personality which is closed or open. The sensitive person who tends to be more withheld and evasive, who leans back in the chair while describing symptoms, is more likely to need Natrum mur. The Phosphorus patient, on the other hand, is very open and expressive of emotion, tending to lean forward and engage the interviewer in personal contact.

Lilium tig. is a highly hysterical remedy, as is Natrum mur. If a Lilium tig. patient experiences rejection or humiliation, however, there is an instantaneous, impulsive reaction; the Natrum mur. patient on the other hand, will suffer inside and wait quite a long time before finally breaking down into a hysterical reaction. Lilium tig. is also more likely to be malicious and cruel during such a reaction, whereas the Natrum mur. person would rather inflict suffering on himself than cause pain to anyone else.

Moschus is another hysterical remedy, but the diffenentiation is quite easy. This type of hysteria is designed for others to observe. It is manipulative, an attempt to emotionally blackmail others into a desired response. Natrum mur. would rather hide any reaction as much as possible.

Pulsatilla is sometimes confused with Natrum mur. Both are intolerant to heat aggravated in the sun, and averse to fat. Pulsatilla•, however, is emotionally highly expressive, automatically giving affection. When a Pulsatilla patient cries (which occurs easily), it is a "sweet" gentle crying, whereas the Natrum mur. weeping is a spasmodic, loud sobbing which shakes the whole body. Pulsatilla patients that are suffering will actively seek help from others and depend on them; Natrum mur. is more self-reliant, preferring to solve problems by themselves.

Lycopodium is a remedy which displays an outer shell created in reaction to an inner state, but internally it is, weak and cowardly. Natrum mur. is strong but emotionally vulnerable to being hurt.

Sepia is closely related to Natrum mur. Particularly in children, they may be very difficult to tell apart. Sepia children are very sensitive, and much more excitable than Natrum mur. In their excitability, they can become flushed and hyperactive. In adulthood, it is as if the Sepia patient has been broken down by this excessive excitability, becoming fatigued, mentally dulled, and apathetic, Natrum mur. feels affection but does not express it easily; Sepia fundamentally has lost it. The Sepia patient is much more likely to be malicious and cruel, almost enjoying hurting others; this would be unthinkable for Natrum mur.