Case Quizes Clinical Cases

Revisiting: Another Sneezer, Another Giant Pile Of Tissues!

Did you guess what homeopathic remedy cured this nose-blower? See below for the answer.

Mom, don’t look now, but, it’s time for the quiz again!

shana-reading-case

And time for my important announcements on matters…

…no one cares about!

Mom, I think everyone wants to hear about our excursion to The Borgata in Atlantic City to see Frankie Valli.

Shana, I don’t think anyone even knows who Frankie Valli is!

Maybe you should explain it.

The best way to explain it is to put on one of his famous records. Actually, this is a great live TV performance from the mid-’60’s.

Frankie Valli and the 4 Seasons, everybody!

 

Frankie’s 82 now but he can still sing! I am so lucky that I got to see a living legend!

Well, on to the Death Report: singer/songwriter Leonard Cohen died.

He was 82 years old. I don’t know the cause of death but two of his famous songs were “Hallelujah” and “Suzanne”. This is a beautiful version of “Hallelujah” (and it’s my favorite cover) by Jon Bon Jovi.

Oh geez, Bon Jovi again?

And before you say anything, Mom… I saw Jon Bon Jovi perform at the Hillary Clinton rally with Barack Obama last week but more on that later. For now, in honor of Leonard Cohen, here is JBJ singing “Hallelujah”.

 

And now for my next announcement: count-down to “Gilmore Girls: A Year In the Life” on Netflix in roughly a week’s time.

Yay!!! I can hardly wait! This is a very well-written show, folks; do try and find it.

It’s a continuation of the original series that ended abruptly in ’07 after Season-7. “A Year in the Life” will be four 90 minute episodes. Here is the official trailer.

 

 

And for my next announcement, Glenn Frey of The Eagles would have been 68 years old on November 6th–if he had lived.

Thanks for the update.

I still can’t believe he is gone. In December the Eagles are going to be honored at the Kennedy Center awards with James Taylor.

James Taylor again???  How many times does he have to be honored anyway????

In case you haven’t noticed Mom, James Taylor is a national treasure!

I think you’re right. I haven’t noticed.

It is going to be so strange seeing the Eagles without Glenn Frey. Anyway, here is one of my favorite Glenn Frey songs, “All Those Lies”.  I sure wish I could find his records on 45 RPM vinyl.

Good grief!

All Those Lies

Oh and I forgot to mention that I went to the Hillary Clinton rally in Philadelphia the night before election day.  Did I mention Jon Bon Jovi performed?

At least 500 times!

Anyway there was an interesting moment where JBJ read a letter from a Philadelphia Republican that basically said he voted for Hillary Clinton.

Apparently, he was the only one!

Well, wait a minute, Mom; we voted for Hillary, and Margie Frank voted for Hillary….

OK, so there were 4 votes for Hillary!

Mom!  There were 50 million people at that rally who voted for Hillary!  And did I mention that James Taylor is a Hillary supporter?

Again with James Taylor.

I don’t have any pictures but I have a not-so-great video of Jon Bon Jovi performing “Here Comes the Sun” by the Beatles.  I knew there was a reason I liked him!  Also it was so cute when getting out of the car to walk towards the rally I heard this little girl say completely out of the blue, “Bon Jovi”!

Maybe she’s insane, did you ever think of that?

Not insane!  Oh and one more thing; on December 12th there’s going to be a documentary about the Rolling Stones’…

Aaaaaaah!!!! Say it isn’t so!

… their 2016 Latin America tour is playing at the United Artists Theater for one night only.  It’s at 8pm so I hope to see it.

Is this something I have to go to?

They played Havana for the first time ever so it should be an interesting documentary.

Or not.

Mom, stop being so negative and introduce our quiz!

Oh right, the Quiz! I knew there was a reason I was here!  OK, so we have a sneezer again! Try and guess the remedy, folks!

***

Hi Elaine, my nose is runny and I am sneezing, what can I take for that?

Oh, and I forgot to mention that my throat is itchy and my nose is super runny. I feel lightheaded too. The runny nose is clear.

Do you have a cold?

Yes it seems like a cold; my nose is runny and keeps on dripping clear fluid, inside my nose it kinda burns. I have wiped my nose many times. My throat is slightly itchy and my body aches a little.

I’ll need you to fill out the acute case questionnaire which is on my website:

 

Questionnaire

Name: Otis Vanderhellenfliegelfein [not his real name]

Age: 30

Gender: male

Weight: 230 lbs

Height: 6’2”

Date: 11/12/16

Email Address:

Describe your complaint–

It came on suddenly, my nose is runny with clear fluid

Etiology–

It’s colder in the area, but I always cover up.

Sensation–

My throat is itchy and feels scraped. My nose is runny with clear fluid 24-7. I sneeze constantly also at times, it has no time

Appearance–

My nose and upper lip and mouth area are chaffed from all that nose blowing,

Location–

My nose, throat, chest feels a little congested. Body aches a little, I feel kinda numb, lite headed.

Modalities–

What makes me feel better is warmer weather or areas. The cold air makes it worse, makes my nose more runny and sneeze more

Concomitants —

Burning sensation inside nose, numb light headed feeling.

Discharges–

Runny nose that’s clear and watery, burns my nose and upper lip.

Generals–

I feel numb, I kinda wanna just lay down.

The mentals–

Well I just feel numb, that I don’t wanna do anything.

What have you been saying?

I wanna be alone, I feel discomfort.

What are you doing?

I am blowing my nose in excess, just trying to rest

Describe your thirst and appetite–

I am more thirsty and more hungry for food in general

Fever?

Slight fever at all times.

Sweating?

none

Odors?

no odors

What is most striking, peculiar or identifying about your condition?

The liquid drips from my nose 24-7

Is there a diagnosis?

Cold

Describe your energy–

I feel dull, like I just wanna rest.

What does your tongue look like?

Normal, healthy pinkish

If you have a cough, please tell what it sounds like–

I have coughed because my throat was itchy

________________

OK, Otis. Take one dose of ____________200C.

In a message dated 11/13/2016 7:54:17 P.M. Eastern Standard Time, ***@yahoo.com writes:

Hi Elaine,

I did try _______________200C. I feel much better. It seems that I am 95% better.

I forgot to mention that i did have a deep sleep and woke up more refreshed, healthier.

____________________

 

Well! I can’t ask for more than that!  What do you think the remedy was?  Write to me at LEWRA@aol.com, the answer will be in next month’s ezine.

Mom, to play us out (still in honor of Leonard Cohen) here is James Taylor’s cover of “Suzanne”.

Oh no!  I’m sorry!  This is Judy Collins’ song–I have to draw the line somewhere!

Bye everybody, see you next time…

___________________________

VOTES

Gelsemium-2

Nux vomica

Phosphorus

Ars-i.

 

OK, let’s see who has the courage to come up and give an answer to this quiz!

Hi, Elaine.  It’s Gelsemium.

Nola Daniel

Thanks for voting, Nola, and welcome to the hpathy quiz!  I understand why you picked Gelsemium.  “Otis” was dull and just wanted to lie down.  But the increased thirst contradicts Gelsemium.  Gelsemium is famous for being thirstless. 

I have to tell you that I was feeling hopeless about finding a remedy for this case until I saw “increased thirst and increased appetite”.  It’s very unusual for a person with a fever to have an appetite–especially considering the fact that he’s got a sore throat and who wants to eat with a sore throat?  Normally, a fever destroys your appetite!  So a symptom like this is a real Red Flag! 

I went right away to the Fever chapter in the Repertory and hoped I would be able to find “appetite increased”; but, alas, no such rubric existed.  So I went to the Food chapter (I have Murphy’s Repertory) and I looked up “appetite” and hoped there would be a subrubric “fever”… and there was!  “Food: appetite, increased, fever, during”–8 remedies but only 1 in BOLD–Phosphorus!  And what else does Phosphorus have?  Increased thirst!  And what else did “Otis” have?  Increased thirst!  So there it was, our remedy, Phosphorus!

So, in solving a case, we look for these gifts, these gems; it’s like rummaging through a cereal box looking for the little gift they’ve hidden inside–a whistle, a charm, etc.  Do they still hide prizes in cereal boxes?  I remember there was always a surprise in a Cracker Jack box:

So this is the scenario, you’re rummaging through the case looking for the hidden “gem”!  You shouldn’t think when you have an acute case before you that your job is to repertorize every single symptom the patient has: runny nose, scratchy throat, wants to lie down, muscle aches, fever, etc.  If that’s all you’ve got going for you, all I can say is, good luck! 

Instead, imagine you’re in a card game and you’re dealt a hand of cards.  You’re holding 7 cards in your hand, and none of them makes any sense all by themselves until you put them in order!  What is your “strong suit”?  Is it that you’ve got all spades?  Is it that you’ve got an Ace?  Is it that you’ve got 2 fours and 2 tens?  In our case, we happen to have an Ace–even 2 Aces:  We’ve got “increased appetite during fever” and “increased thirst”.  That’s what I went with.

Last month’s case was another sneezer, remember?  “Wonder Boy”?  How did I solve that case?  I found an Ace: “loose cough but can’t expectorate”.  That’s a big red flag for Antimonium tart.  Then, in looking up Antimonium tart, I found the whole rest of the case there–irresistible desire to sleep, delirium (which the mother described as “babbling”)–disagreeable mood, thirsty for sips at a time…and there it was, practically every aspect of the case fit Antimonium tart.  But it all started with finding the “gift” in the cereal box–“loose cough, can’t expectorate”.  That was the gift.  Did you see the answer to last month’s quiz?  Due to the fact that everybody thought the remedy was Arsenicum (“thirsty for sips at a time and restlessness”), I actually posted a video of an Arsenicum flu so that you could see it for yourself.  Click below and the video is on the last page, I believe:

Revisiting: “Wonder Boy” Sneezes 100 Times, Uses Up 100 Tissues!

If you missed it, please click on the link above.

Thanks for voting, Nola; hope to see you again next month!  Is anybody else here?  Oh look, it’s the twins from Slovakia!

Mom, they’re not twins!  

 

Hello, Elaine and Shana.

Hello Miroslav and Jitka!!!

Here we are again with our desperate attempts to guess your instructive quiz.

I’m sure you’ll do fine!

Miroslav guesses Gelsemium

D’oh!

In this case I was most impressed with fatigue, the whole body aches, vertigo and also nasal symptoms which suggest Gelsemium.

See, here’s the problem.  None of that is impressive!  When you have a virus with a fever?  It’s all very common–fatigue, body aches, nasal symptoms, and by the way, there’s no vertigo here.  Vertigo is very serious.  He says he feels “light-headed” which is nothing and very common considering he has a virus and a fever, but, there is no vertigo, the light-headedness is very minor.

However, patient claims he was thirsty, which could virtually rule out this remedy.

Yes, it actually DOES rule out the remedy!  That should have been the end of Gelsemium!

But Gelsemium can feel thirsty when perspires (what the patient did not mention)

But “Otis” had no perspiration.  The questionnaire asks about perspiration (sweating) and he said no.

In Phatak´s MM Gelsemium is said to be usually without thirst, which means not explicitly without thirst.

OK, OK, here’s the thing: we can’t start picking remedies based on their exception!  We would have to have a compelling reason to pick a remedy on that basis.  It’s a fact that just about every remedy that’s in BOLD for a symptom is also in “plain type” for the opposite symptom!  Phosphorus, for example, is Bold/Underlined for “Thirst” but it’s also in plain type under “Thirstless”!  Does that mean that when we see a thirstless patient our first thought can be Phosphorus?  No!  We’re going to be thinking of Pulsatilla or Gelsemium or Belladonna in such a case–not Phosphorus, unless we have some compelling reason to consider it; like for example, let’s say the patient says, “I’m not drinking any water!”  So naturally, we’re going to think he’s thirstless, right?  But then we get suspicious because he’s also saying that he’s scared of the dark, scared of ghosts, wants company and is better for consolation.  So we’re going to think, “Well, I’m not comfortable giving Phosphorus because he’s not drinking; but, most of the case has Phosphorus written all over it; and, well, Phosphorus IS a 1 under “Thirstless”, so, maybe I should go with it.”  So you give Phosphorus and the patient gets better!  And he says, “I’m so much better now, and that burning thirst is gone!”  And you’re like, “What burning thirst?”  And he says, “Yeah, I was sooo thirsty!  But drinking water made me throw up, so I wasn’t drinking anything!”  YOU NEVER ASKED HIM why he wasn’t drinking!!! 

Always ask the patient “Why?”.  “Why aren’t you drinking?”  Some remedies like Belladonna are thirsty but have an aversion to drinking!  The rabies remedies are like that–Belladonna, Stramonium, Hyoscyamus.  As rabies remedies, you can imagine that they have an aversion to water.  

But, here’s what you’ve done, here was your reasoning: “The common symptoms of this illness (which I’m NOT supposed to be prescribing on) match Gelsemium; so, I’m going to go with it, even though Gelsemium is thirstless and the patient is thirsty.”  No, no, no, this is very bad reasoning!  Throw OUT the common symptoms!  If the illness explains the symptoms, then they’re not symptoms–to US!  They may be symptoms to the doctor, but they’re not symptoms to us.  So if a person has a fever and he’s light-headed, that’s COMMON, the fever explains it!  Fevers will do that, just ignore it!  And if a person has a headache with a fever, just ignore it, and if he has body aches with a fever, just ignore it, UNLESS there’s something peculiar about it!  So really, all you’ve got so far, as a “symptom” that means anything to us, is “increased thirst”!  Is Gelsemium going to be your first thought for that?  No.   

Here’s how you can be misled in a Gelsemium case:  The patient isn’t drinking so you conclude he’s not thirsty.  Meanwhile, in typical Gelsemium fashion, and unbeknownst to you, he asked for water, it was brought to him, and he was too apathetic to reach for it!  Apathy is a hallmark of Gelsemium!  You would assume, “Hmm….he’s not drinking, so he must not be thirsty, so it must be Gelsemium!”  The fact is, if you would put the glass in his hand, he might drink it!  You know what a thirsty Gelsemium is?  Baptisia!  When you see someone who, for all the world, looks like Gelsemium except he’s thirsty?  Think of Baptisia, especially if the patient smells bad!  If he doesn’t smell bad, you’re still between Gelsemium and Baptisia–unless he’s guzzling down water, in which case, you would have to go with Baptisia.  So remember, Baptisia is apathetic, droopy, drowsy, dizzy and dull, just like Gelsemium, except he’s thirsty, smells bad, and seems a lot sicker!

My first thought was a routine remedy–Allium cepa, but it is ameliorated outdoors, which doesn´t fit here.  Arsenicum would be very restless and have burning discharges from eyes.  Also Rhus-t. came to my mind but he wouldn´t want to rest probably, there would be restlessness.  It could be Nux-v. too but this remedy is very nervous, there would be a kind of anxiety.

“Nervous” and “anxiety” are a bit too general as they might apply to anyone.  Nux vomica is impatient, rushed, irritable, angry, demanding, rude and hypersensitive to the least impression, whether it’s too much light, noise, a draft of air, cooking odors…everything gets on Nux vomica’s nerves!

Jitka guesses Nux vomica

D’oh!

Now I feel like Socrates, “I know that I know nothing.”  I lingered among several remedies that are susceptible to colds and have a lot sneezing and watery discharges in their picture, but there was always something that didn´t reflect completely the complaints of “Otis”.  Finally I decided for Nux v.  Nux v. is very chilly and has aversion to cold.  He is aggravated with cold and ameliorated with warmth.  He must be covered in every stage of fever and chill.  It has acrid watery coryza, a frequent sneezing.  It is also in the rubric: Throat; scraping; with capital letters.  I’m just embarrassed that Nux v. has no nasal discharge in the night, only during the day.  So I guess something is probably wrong with my guess.

Yeah, I guess so.  It’s true that Nux v. is a big sneezer; the problem is, there are about 100 remedies under “frequent sneezing”.  The coldness–he doesn’t actually say he’s cold.  He says if he goes out in the cold the sneezing gets worse.  Nux v is actually very cold and worse slightest draft of air.  They are also very irritable and impatient when they’re sick.  So, the mentals don’t match.  Although I can see trying Nux vomica, I wouldn’t have much confidence in the outcome though.

You have both missed the peculiar symptom in the case; not that frequent sneezing isn’t peculiar, it’s just that there are so many remedies to choose from in that rubric, it’s not going to help us.

About the author

Elaine Lewis

Elaine Lewis

Elaine Lewis, D.Hom., C.Hom.
Elaine is a passionate homeopath, helping people offline as well as online. Contact her at LEWRA@aol.com
Elaine is a graduate of Robin Murphy's Hahnemann Academy of North America and author of many articles on homeopathy including her monthly feature in the Hpathy ezine, "The Quiz". Visit her website at:
http://elainelewis.hpathy.com/ and TheSilhouettes.org

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