Case Quizes Clinical Cases

Revisiting: Fifi Again, 3 Years Earlier

Fifi’s got another virus–did you try and guess the remedy?

Mom, it’s time for the quiz again!

I would like to start my announcements by saying that Paul McCartney turns 74 on June 18th.

How come he looks better than I do?!

Well, Mom, he’s a vegetarian, and I’m guessing he doesn’t eat like a pig.

Oh.  Well, that explains it.

Also, countdown to the Paul McCartney concert at Citizens Bank Park!

Right!  On July 17th!

No, Mom, it’s July 12th!!!!

Really?  OMG.  We’d have been late!

Mom!!!  What’s the point in even having a calendar??  Here is a very interesting clip I found of Paul McCartney on the Conan O’Brien Show.  (Isn’t he adorable?)…

Who, exactly?

Back then, Paul was promoting his solo album “Flaming Pie”.

No one cares, Shana!  But seriously, I have to admit, this was the funniest interview I’ve ever seen in my life!  I laughed so hard I was in tears!

It’s so obvious Coney is a Beatles fan.  I saw a video of him from four years ago when he still had his beard.

Who, Paul?

No, Coney!  Mom, please try and keep up!  Anyway, I have one other famous birthday to announce.  Drake Bell of “Drake and Josh” turns 30 June 27th.

I can’t believe I’ve been watching him on TV since he was 15.

I can’t believe it either!

I remember him from “The Amanda Show”.  He looked so young back then.  He was in a great sketch where he did a New York accent.  I’ve been trying to copy it: “F’get about it! F’get about it!”

Keep practicing, you’ll get it.

“F’get about it!”

OK, you know what?  We’re really getting off the beaten path here.  Do you have any announcements that might remotely be of interest to our Indian and Pakistani readers?

I had something to say about Dan Schneider, the creator of “Drake And Josh”.

No, no, no!  Nobody cares about Dan Schneider!

And I also can’t believe that “Drake And Josh” has no complete-series DVD set!

Earth-shattering as that is, we really have to move on.

Can you believe I never taped the 2008 “Drake And Josh” Christmas special?

Do I have to answer that?

You have no idea how much I want a “Drake And Josh” reunion!

Even more than a “Kenan and Kel” reunion?

Even more!  By the way, my favorite episode of “Drake And Josh” is from Season 3 and is called “Sheep Thrills”.  I’ll try to sum it up for you. 

Oy vey…..

It seems little sister Megan bought a sheep online…

Shana!!!!!  We really have to move on!!!!!

I was just going to talk about the “Dick Van Dyke Show”!

Oh.  Well that’s different.  Never mind!  Did you know that Dick Van Dyke is supporting Bernie Sanders for president?

It seems that Dan Schneider was a fan of the “Dick Van Dyke Show”.

We’re back to Dan Schneider?????

Mom, if you can possibly be patient, I was trying to say that Dan Schneider…

This is the most press Dan Schneider has ever gotten in his life!

…was so enamored with sitcoms from your day, that he worked classic scenes from “I Love Lucy”, “The Dick Van Dyke Show” and “Family Ties”, etc. into all his shows!  Did you see Drake and Josh re-enacting the classic Lucy and Ethel chocolate factory sketch, it’s called “I Love Sushi”.

Very clever.  No I didn’t see it.  Do you have anything else you’d like to report on?  

We saw “Vaxxed”!

Well, where’s your review?

Mom, you know I’m not good at writing reviews!

This has to be a separate article anyway, or no one will see it but Maria, Wayne, and the Gang from Slovakia.  Besides, you know what?  We’re missing a very important announcement!

We are?

Yes!  Muhammad Ali died!

Oh, I forgot!

I knew we had something important to say!  He was famous — not just for being a real character, but he was the heavyweight boxing champion of the world; AND, he refused to fight in Vietnam!  (“I ain’t got no quarrel with them Viet Cong!”)  He was jailed for refusing to go to war, and they took his boxing title away.  This is mainly why he’s so famous–his courage.  He truly is and ever will be, “The Greatest Of All Time!”  Peace, my brother!

And now, on with the Hpathy Quiz!

Who is the patient?

It’s Fifi again, only she’s 6 years old this time.

What’s wrong with her?

Another virus.  Here’s the case.



Name: “Fifi”

Age: 6

Male or Female: Female

Weight: 38 pounds


Date: January 25, 2013

Email Address: k****

  1. Describe the complaint

On Tuesday, around 5 pm, Fifi started sneezing; within the hour, she had also a small cough, wanted to be held and was in a rapid decline; she started a fever … not measured but probably not above 102; in the night, she was a little restless and did best when she had her head on me; her cough … I think was croupy; it is now lessened and may be ‘dry’; the second day, she was again worse starting when the sun went down.

  1. Etiology–

Well, her School had her outside in the cold with no gloves or boots in 20 degree F. weather! This all started 2 hrs after that.

  1. Sensation

Headache, tummy pain (not consistent)

  1. Appearance

    Red cheeks, white tongue … with strawberry look to it. Swollen glands; her nose was a little irritated at the edges.

  1. Location

    (no answer)

  1. Modalities

Definitely worse in the evening – Wants me to touch her, but not her little sister, wants my company, but no one else; wants tea (lemon), warm juice, hot chocolate; in the night, did have extreme thirst for water. Likes to be under a blanket; when not covered, she has goose bumps.


7. Concomitants

sneezing – the last two days; not as much now; some runny nose, but not really able to blow it all out, just a little in a tissue at a time.

her eyes are getting a little puffy

  1. Discharge

no real color.

  1. Generals

thirsty at night, wants company, wants to be held … only by me.

  1. The mentals

pretty neutral, she is patient about asking for stuff from me … like water, etc. Her voice is sometimes hoarse. but not really irritable.

  1. What have you been saying?

I don’t want my sister to touch me.

  1. What are you doing?

Playing games on ipad, alert, engaged in movie or game, not too talkative, but certainly not inert, but not playing with the energy of a 6 yr old– all activity is on the couch.

  1. Describe your thirst and appetite–

Some thirst … but not constant, warm drinks, really had a big thirst at night for water.

  1. Fever?

Mostly a night fever, dry.

  1. Sweating?


  1. Odors?


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

The weird looking tongue. Fever. Sneezing at first.

  1. Is there a diagnosis?

My self diagnosis, based upon her tongue, is scarlet fever.

  1. Describe your energy

Restless during sleep.

  1. What does your tongue look like?

White with strawberry seeds.


If the fever comes on at night, and the thirst comes on at night, is it safe to say that Fifi has fever with thirst?


Give her _________________ 30C two doses in two hours.



I only got two doses in before she fell asleep.

Been peaceful with no restlessness and no fever.

Next day:

She has energy and is laughing and making movies

but she still has runny nose and coughing.

“Healing takes place from the inside out”, so, this outcome is just what we want to see. Stick with _________________30C.


OK, everybody, what was the correct remedy used for this case?  Write to me at [email protected] and let me know.  The answer will be in next month’s ezine.

We are going out with this great clip I found of Muhammad Ali and Joe Frazier on The Dick Cavett Show, you can see what a larger-than-life character Ali was.  He was a national treasure, we will all miss him. 

See you again next time…







And now, the moment you’ve all been waiting for, time to reveal the answer to last month’s quiz!  Who wants to be first this time?

Hi Elaine and Shana!

Hi Maria!!!!  Step right up to the microphone…

For this month’s quiz I had to choose between Arsenicum, Belladonna and Rhus-tox.  But Rhus tox is not under “Strawberry Tongue”.

I wasn’t really that interested in the strawberry tongue rubric.  It had a lot of strange remedies in it that didn’t really relate to flu-like symptoms–remedies like Sapo., Ter., Tuberculinum, Frag., Ptelea trifoliata, Mez. … I mean, sometimes, before you get all excited about a rubric, look at the remedies in it and see if it makes any sense.  Argent-nit was listed as a 2, Bacillinum was a 3, and all the rest were in plain type, not exactly a ringing endorsement; so, I thought it best to let this one slide.

That leaves us with Arsenicum and Belladonna.  Belladonna is not under thirst with fever but Arsenicum is.

Yes, but we have no confirmation for Arsenicum.  There’s no anxiety, no fear, no prostration, no restlessness other than during sleep.  You know, generally speaking, Arsenicum patients are very sick.  They’re so sick, they’re afraid they’re going to die, and they beg for company and reassurance. This child is well enough to play on the couch during the day.  The mother says her mentals are “neutral”.  So, I can’t go for Arsenicum with this one.  As for Rhus tox, the child isn’t restless–other than during sleep.

The bright red face fits with Belladonna.

I don’t think she said “bright” red, just red, which has over 200 remedies in it, so, it’s not going to help us that much.

I would go with Belladonna first, although it doesn’t cover the thirst.  But, as you said in another quiz, when a symptom fits a state it’s not a symptom.

Are you saying that because it’s normal to be thirsty during a fever, we can’t count it as a symptom?  Yes, BUT, but, but, but, but, but; if it’s “extreme”, you have to count it!  And the mother uses the word “extreme”.  “Extreme thirst at night,” she says.  Oh, and coincidently, “fever at night”.  What does Hahnemann say?  “Striking, strange, rare and peculiar.”  So in this case, the thirst is “striking”.  The rubrics I took were “fever with thirst”, “thirst at night”, “fever at night” and “evening aggravates” which she made a point of saying.  So, that was basically what I used as being characteristic about this virus.

Belladonna is my vote.

But, why can’t it be Belladonna?  There’s no fever with thirst under Belladonna; so, we can’t use it.

If I am wrong I will try again.


Ok, now I am between Phos and Pulsatilla – mostly because of the clinging to mother more than usual.  They are both under the rubric you said in different degrees:
Fever, night: PHOS, PULS

Fever, thirst with: PHOS, puls

Thirst, night: Phos, puls

Evening agg: PHOS, PULS

Also there are these rubrics.

Thirst, fever during: phos, puls

Thirst, extreme, with fever: phos (only two remedies, the other one is arsenicum)

No, the other one is Alumina!

I will go for phosphorus.  If I am wrong, I will try again 🙂

Yes, it is Phosphorus!  I completely missed “thirst extreme with fever”!  Good one, Maria!  If I had seen that right away, I wouldn’t have had to look any further!

(Oh yes you are right, it was Alumina in that rubric with Phosphorus, not Arsenicum. )

I am thinking that the strawberry tongue should interest us as a rubric, because it is not common at all.

You know, we now have a documented case of strawberry tongue with Phosphorus.  Now if only people would write to us and let us know if they see this showing up in their Phosphorus cases, we could make a new addition to the Repertory!

Great work Elaine!  Thank you!

You are soooooooooo welcome!!!!!!!!  Oh, don’t look now, but, Miroslav and Jitka just flew in from Slovakia!


Hello Elaine and Shana,

Hello Miroslav and Jitka!!!!

As you can see, our motto is “Never Give Up” and despite our systematic failures, we are going to try our luck at your quiz again.

Hey, you don’t ALWAYS fail!!!!!

Miroslav votes: Arsenicum

Again a nice “bunch” of symptoms, so how to begin …?

Aggravation, evening.

Well there’s a problem right there; Arsenicum’s aggravation time is between 12-2 a.m.!

Wants to be held.

What 6 year old child doesn’t want to be held?  It doesn’t help us; it’s COMMON!  Common symptoms will get us nowhere.

Restless sleep, viral fever with thirst, wants to be covered …

The rubric is “Fever: chilliness with”

…that could be typical for Arsenicum.

It is, but the rubric itself has almost 60 remedies in it.

I was thinking about Phosphorus too, but it is not in the rubric “restless sleep”.

Actually it is in “Restless Sleep” as a 1 in Murphy’s Repertory.  The remedy was Phosphorus.  How do we know?  Thirst at Night, Thirst with Fever and Evening Aggravates.


Jitka votes : Belladona

It seemed to me that you prescribed a remedy for Fifi on the basis of: diagnosis of scarlatina and fever with thirst.

But Belladonna is thirstless with fever.  Plus the child’s mentals are “neutral” as the mother said.  Belladonna’s mentals are quite, agitated, intense, distressed.

I looked in the chapter Diseases (Clinical) in Murphy’s, there were many remedies, but in the rubric “high fever with delirium and thirst”, there is only Belladonna and Dulcamara.

But there’s no high fever or delirium here.  You looked in the wrong chapter.  The chapter is “Fevers”.  The rubric is “Fevers: thirst with fever”.  Belladonna isn’t there; although, I’m sure Belladonna CAN be thirsty some of the time; but, by and large, what Belladonna is famous for is NOT being thirsty.  If we see a thirsty person with a fever, our first thought is not going to be Belladonna unless everything else in the case leads us to suspect it—as in the example you just gave: high fever and delirium.  It would be hard to ignore Belladonna in such a case.

Although Fifi didn’t have delirium, Belladonna is everywhere emphasized as the first remedy to be considered in scarlet fever.

I just ignored the mother’s “diagnosis”.  Look for what is striking in the case.  It’s hard to ignore the thirst at night.  The mother called it “extreme” and “big”.  When patients use words like that, you have to make it your priority.  So what do we have here?  Fever coming on at night, evening aggravation, thirst with fever, thirst at night.  There’s actually a rubric Maria told me about, it’s in Murphy’s “food” chapter: “Thirst extreme with fever”.  Only 2 remedies: Phosphorus and Alumina.  We can eliminate Alumina since it’s not a flu remedy; so, it’s easily Phosphorus and Phosphorus fits all aspects of the case.

Is anybody else here?


Hello dear Dr. Elaine, I think this time you gave Aconite 30C.


Salma Afroz

Salma, here is my repertorization:

Thanks Dr. I am so sorry Phosphorus was in 1st position and Belladonna was in 2nd position.  Except 1 rubric I couldn’t find:  Cold, temperature, weather, ailments from.

It’s in “Generals”.

So I thought Belladonna could score more.

It can’t be Belladonna.  Belladonna is known for being thirstless.  The most characteristic symptom in this case was the thirst at night.  The mother said it was extreme, big.  Coincidentally, the fever came on at night too.  So I used “fever at night”, “thirst with fever” and “thirst at night”.  Also, the patient was too calm to be Belladonna.  The mother said Fifi’s mentals were “neutral”.  Belladonna’s mentals are often intense and as a result the parent is in a hurry to do something fast!  Remember, Belladonna is a rabies remedy.  Here’s what Murphy’s Materia Medica says about Belladonna:

“Belladonna stands for violence of attack and suddenness of onset.  Belladonna is often associated with hot, red skin, flushed face, dilated pupils, throbbing carotids, excited mental state, hyperesthesia of all senses, delirium, restless sleep, convulsive movements, dryness of mouth and throat with aversion to water…”

My bad.  You are so right.  I couldn’t even recognise Belladonna.

I did mention that the remedy was Phosphorus, didn’t I?  Phosphorus is famous for thirst, especially for cold drinks, and they often wake up at night to drink water.

You are so vigilant while analysing a case.

I is?  Wow, thank you!  I had no idea!

It’s amazing.  Thanks a lot.  It’s great to learn from you.

Thanks, Salma!  I think we’ve all learned today that Phosphorus is famous for thirst, especially for cold drinks, thirst at night, and extreme thirst with fevers.

And now for a very special treat brought to us by Shana:  Paul McCartney makes mashed potatoes:

See ya next time!

Elaine Lewis, D.Hom., C.Hom.

Elaine takes online cases! Write to her at [email protected]

Visit her website:


About the author

Elaine Lewis

Elaine Lewis, D.Hom., C.Hom.
Elaine is a passionate homeopath, helping people offline as well as online. Contact her at [email protected]
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: and


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