hi elaine,

not finding the same remedy in all the rubrics. seems like this must happen alot when assembling a case? or does this happen in only the “difficult” cases?

Kelly

Dear Kelly,

You’ve asked a profound question. This is why homeopathy is so difficult!

We say we take the totality of symptoms, but as you’ve pointed out, if you go to the Repertory (our reference book) and look for the symptoms in the case, you rarely find that there is one remedy that covers the whole thing.

For example, if you have a runny nose and sore throat with amelioration (improvement) from stormy weather, you may see that you can’t find a single remedy that covers the whole case. So, how, under the circumstances, does one pick a remedy? It seems to suggest that you have to disregard some of the symptoms as being irrelevant or less important, and that’s exactly what you have to do!

The symptom with the most value in this particular case is “Stormy weather ameliorates”! Why? It’s because it’s the only individualizing symptom in the case!

It doesn’t occur to the average person that we all have colds differently! And it’s how we’re different, in homeopathy, that leads to the correct remedy.   Everything else in this case is like everyone else’s cold–except for this one thing; therefore, that’s what’s going to unlock the case for us!

This is how homeopathy works–it’s the peculiar symptom, it’s the striking symptom that you can’t ignore, which might seem unrelated to the complaint and not very important at that, that points the way to the remedy. So, in this case, you’d check the Repertory for “Generals: storms amel.” (Murphy’s Repertory) and there’s only 3 remedies!  So, from three thousand, we’re down to 3!  That’s pretty darn good! 

Here’s the problem with the Repertory:

1. Some remedies were very extensively tested on volunteers and have hundreds of years of clinical use, and are, consequently, over-represented in the Repertory. Remedies like Sulphur may show up in almost every rubric from Bloating to Vertigo and so a strict repertorization will almost always show Sulphur as the “winner” every time!

2. Other remedies are under-utilized, are poorly represented in the Repertory and will never “win” in a strict repertorization!

3. There are numerous symptoms in the Materia Medica (our other “Big Book”) that were never entered into the Repertory! For instance, the remedy Chocolate isn’t in the rubric “Abandons/Forsakes His Own Children”, that’s just one example. (Simillimum, summer 2003, p. 48)

So we can see that we have to have some other strategies going for us other than strict repertorization to solve a case.

What might those strategies be? Well, different homeopaths have lots of tricks up their sleeves, but here’s a few I think we would all agree upon:

1. The most recent symptom takes precedence. The most recent symptom in a case can’t be ignored in favor of the ones we find more interesting.  A newly-acquired tendency to cry at the drop of a hat might suggest that this person needs Pulsatilla now, even though the rest of the case might not support it.

2. SUFFERING in the case takes precedence. If someone has pain, you have to hone in on that, you have to take the case of the pain, even though you may suspect that your patient is constitutionally a Sulphur or a Calc-carb. When you see a person with, for example, a Bryonia pain–sharp, stitching pain, worse for the slightest motion–you have to give Bryonia right away, it doesn’t matter that he sticks his feet out of the covers, is messy, doesn’t like to bathe, and other symptoms we associate with Sulphur.

3. Find the worst thing when you don’t know what to do, or there’s more than one thing going on at once! When there seems to be a million symptoms in the case, and there usually are, ask your patient, “What’s the worst thing that’s the matter with you right now?” Then take the case of whatever that is. He may say, “If I didn’t have insomnia, a lot of my other problems would go away, I wouldn’t be so dizzy and nauseous and weak.” So, the case then becomes one of insomnia–you’d ask him to describe it, what does he think about while lying awake, does he wake at a certain time each night, what may have caused it, and so on.

4. Look for what’s excessive in the case: Too much talking, too much sweating, too much dryness, too much…whatever.

5. Find the over-sensitivity: Look to see what the person is over-reacting to: Criticism? Rainy weather? Music? Sunlight?

6. The patient’s response to stress–is there a pattern? You may find that this is a person who cries about everything, or over-reacts violently to everything, or feels that he can’t ask for help, despite having these stresses in his life. The RESPONSE to stress is more important to us than the fact of having a stress, per se.

7. The cause. Very often if we know the cause, we can pack up our bags and go home! The cause determines many or possibly even most of our prescriptions! “You’ve had this since the accident? Oh, why didn’t you say so? The remedy’s Arnica!” “You had this since your boyfriend broke up with you? Why didn’t you say so! The remedy’s Nat-mur.” “You’ve had this since the flu? Why didn’t you say so? The remedy’s Gelsemium!” (I’m over-simplifying, I know, I know.  BUT, sometimes it IS that easy!)

In general, when confronted with symptoms which don’t fall neatly under the umbrella of one remedy, THROW OUT THE COMMON SYMPTOMS right away–symptoms like “Sore Throat”, “Headache”, “Runny Nose”–symptoms which could be any one of 500 remedies, it’s not going to help you unless you can get the patient to elaborate!  For instance, “Sore throat, better from talking.”  There might only be one remedy that covers that, that’s how peculiar that is!

THROW OUT EVERYTHING THAT’S NOT INTENSE.

Look for what’s PECULIAR.  Now, I know, you’re going to say, “Elaine, I always ask my patients if there’s anything peculiar about them and they always say No!”  It’s because you can’t ask them that way!  You have to say, “Is there anything that OTHER people think is peculiar about you?  Now think about it: When have people said, ‘Why can’t you do that?  What’s the big deal?  Why is that so difficult?’  In fact, what have your well-meaning friends or family members tried to change about you?”

Look at what’s RECENT.

Look for SUFFERING.

Look at what’s STRIKING about the person.

Look for a THEME (always crying, always talking about birds, etc.)

Ask what’s the WORST THING in the case (generally, pathology on the MENTAL/EMOTIONAL plane, if intense, tends to be the worst thing–fears, anxiety, delusions, for example, can cripple a person worse than a broken leg).

Look at how the person RESPONDS to his complaint.  Think about it:  Denial?  Panic?  Paralysis?  Fear?

Find out what he’s HYPERSENSITIVE to.  In fact, you might say, “What evokes strong emotions or strong reactions in you?”

What is he doing and saying?  He might have some odd trait like swinging his legs, slouching, looking away or blinking; he might keep saying, “I’m really worried about this, I’m really worried about that…..” or every other word might be a curse word.

See if you can separate the symptoms into acute and chronic and treat acutes first, brushing the chronics aside for later.

Look for the CAUSE.

In the final analysis, instead of 30 symptoms in the case, you may find that you’re down to 5 or 10!

So, for example, in a Chocolate case, regardless of the diagnosis–arthritis, or menstrual cramps, etc.–the rubrics or symptoms you might finally decide upon may look like this:

Desires chocolate

Ameliorated (better) in the countryside

Ameliorated by curling up in a ball

Aggravated by the presence of her children

Desire to travel/escape

(These really are Chocolate symptoms, I’m not making this up!)

So, it’s what’s unusual, excessive, repetitive and striking that matters, and remember to treat the suffering first and look for causes.

If there are “layers” in a case, each layer will begin with a CAUSE, which will shift a person over to a new remedy picture–or, it might take him deeper into his own constitutional state; for example, there’s the “healthy” Sulphur person who’s ambitious, pursuing a career, getting good grades, warm body temperature, loves the outdoors, extroverted, active, and so on; and then there’s the ”unhealthy” Sulphur, who’s reclusive, stays indoors, is chilly, and has become lazy and stopped trying. A healthy Sulphur, after failing repeatedly in business, for example, might take on this new state, but it’s still Sulphur.

Try to see what the critical “events” in the person’s life were. There is a set of remedies that corresponds to each event–remedies for the flu, remedies for loss of a loved one, remedies for injury, remedies for business failure, etc.

If you see that a person has never been the same since a significant event, the symptoms themselves become less important and the CAUSE becomes paramount, and you would want to try to match a remedy from the CAUSAL rubric to your case.

Soooooo……….When did Kelly leave? Now, see, that’s very peculiar! “Unable-to-sit-through-a-rambling-interminable-explanation”. I’m thinking Sulphur!