Case Quizes

Quiz #2 -Exhausting Diarrhoea in A 19 yr old Woman

Petr Zacharias, founder of the Prague College of Classical Homeopathy, presents Quiz #2 in his series.

Dear Friends,

Here is another quiz for you. Find the remedy according to the information given below and justify your prescription.


First interview:

Young lady 19 years old suffers from exhausting diarrhoea for last 8 months. Diarrhoea is irregular but she has it twice a week at an average. Before this diarrhoea appeared for the first time, she found herself very much aggravated by eating fat food (3). Diarrhoea is very changeable (2) in its appearance but only thing that is all the time the same is the pungent odour of the stool. She is complaining about sensation of heaviness in stomach (2) which is always at the evening. If this heaviness happens, she knows that the next morning she is going to have diarrhoea. After the diarrhea the pain in stomach that preceded diarrhoea is much better (3). Last 8 weeks she suffers also from recurrent acute gastroenteritis with fever about 39°C. She does not used to suffer from repeated acutes so frequently before that period of time. At the time when all problems started her boyfriend has been unfaithful to her. Thirst is a bit less than normal, about 3/4 liter per day.

Observation: She responds to my questions in a way that she seems to not understand what I am asking for. I must make a thoroughful explanation of even very simple questions.


Her sleep is also disturbed in irregular way, which means that one week is normal and other week wakes up at 3:30 a.m. but she is able to fall asleep again within 30 minutes. Fells very exhausted (3). Since her problems started she tends to be more and more closed emotionally, her mood swings up and down, she is quite irritable towards people and says spontaneously that she does not feel well when seeing other people happy (3). She describes her mental state as a kind of hysteria (2), she loathes everything. She suppresses all emotions inside and when come home, she cries out hysterically, her body is stiff all over. During such episodes she has intense headache and must be alone when weeping as she does not want to be disturbed by anybody. She does not have either lump sensation anywhere or sobbing or difficult respiration.


1st follow up 2 months after the remedy:

There was an acute gastroenteritis 2 days after the remedy but it lasted 2 days only and then she experienced marked amelioration of chronic diarrhoea which is now about 80% better compared to the state prior to the remedy. She feels much better psychologically, look forward to every day, enjoys preparing for final examination in school and her energy is much better and spontaneously says that she does not feel exhausted anymore. She does not remember when her mood swung up and down as she feels emotionally stable and does not have any problems to see others happy anymore. After the remedy she developed dry eruption on her forearms and upper part of lower extremities. She never had an eruption of any kind in the past. The irritability from trifles diminished completely. The skin on her face is getting worse.


2nd follow up 3 months after the remedy:

She has been free from diarrhoea except 3 episodes when she was under very strong stress due to final examinations in the school. Except these 3 episodes, she is free from diarrhoea. Energy is very

good and she spontaneously says she enjoys life and school to the full and have desire to spend her energy in activities that serve to the others. Eruption diminished by itself and overall she feels great.

Take some time to ponder what remedy you would choose, THEN POST YOUR ANSWER AS A COMMENT. …and then see the answer below…..



Analysis of the case for students of homeopathy

From the very beginning it looks to me as a perfect case of Pulsatilla as she has a strong aversion to fat, thirstlessness but mainly due to the changeable character of stool and her mood. I perceived from very beginning something on her but I was not able to identify what it is. I was listening her story and started to doubt about Pulsatilla when she said that she becomes more and more closed, wants to weep alone and does not want to be disturbed by anybody and has aversion to be consoled.

So I left the idea of Pulsatilla and kept listening to her and then she said: “I dont want to see other people happy“. I knew that there is a rubric in repertory for this symptom and what surprised me most was that she used the exact sentence as is the name of this rubric. If I looked at this rubric there was a Helleborus and Helonias as main remedies and then I saw the bigger picture. The thing I was not able to identify was the way she was answering my questions as she needs a lot of time and effort to be able to answer me to very simple questions. I said to myself: this is a case of Helleborus as it has very similar depression to Natrum muriaticum but with dullness of mental faculties.

Dr. Kent in his book Lectures on Materia medica wrote: “When able to be about the patient appears to be sad, because she sits and says nothing, and seems to be in a woeful mood. But there is not that great lamentation, with walking the floor and wringing the hands that we find in Aurum. It is an apathetic state; she appears sad and melancholy, whereas perhaps she does little thinking. Any attempt at consolation, so long as the patient is able to think, only aggravates the trouble. Like Natrum muriaticum, the complaints are aggravated by consolation, but the complaints of Natrum muriaticum are not at all like these.

In Hering´s guiding symptoms it is said: “Irritable ; easily made angry ; < from consolation, does not want to be disturbed.” In the chapter STOOL in guiding symptoms: “diarrhœa preceded by colic, which is > after every stool.

Helleborus could be very similar to Natrum muriaticum and also is one of the main remedies listed in rubric: ailments from love disappointment.

Hope you enjoyed this quiz,


About the author

Petr Zacharias

Petr Zacharias is the founder and main teacher at the Prague College of Classical Homeopathy. He studied with George Vithoulkas at the IACH and has conducted seminars with Dr. A. U. Ramakrishnan, Dr. S. K. Banerjea, Dr. Jorgos Kavouras and Erik van Woensel.

1 Comment

  • I like your case analysis, which shows strong knowledge of materia medica and sound classical technique.

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