Case Quizes Clinical Cases

Revisiting: Shana Sneezes

This was a tricky one, I know! Did you get the right answer?

To read last month’s full case quiz. Visit – Shana Sneezes




Rhus tox



Well, it looks like this case caused everyone to go screaming out of the room!  Maybe someone’s on the phone.  Is the caller there?  Hello!!!  You’re on the air at!

Hi Elaine, these are rubrics I choose:

Extremities; eruptions; itching; knees; hollow of

Skin; eruptions; summer; agg.

Skin; eruptions; urticaria, nettle-rash; recurring

I never said it was urticaria.

Generalities; summer; agg.

Too general. “Skin, eruptions, summer” is better.

Generalities; sneezing; agg.

No, not Generalities; go to the Nose chapter; “Nose: sneezing”–and in this case, “Nose: sneezing, violent”.

Now listen, there’s a trick I have to share with you!  Very often the key to finding the right remedy is in the concomitant.  The concomitant is the “along with” symptom.  For example, any case with nausea or vomiting as the concomitant is usually Ipecac!  Menstrual cramps with nausea and vomiting–Ipecac.  Asthma with nausea and vomiting–Ipecac.  Headache with nausea and vomiting–Ipecac.

In Shana’s case, we really don’t have much to go on–except for her concomitant, which is the rash, and luckily, we already know what the remedy is for that–Histaminum!  It always works!  So there’s no need to repertorize her rash symptoms because we already know the remedy; so, Shana’s sneezing remedy, is–drum roll please: Histaminum 30C!

The way I understand is that Histaminum didn’t work and that is why the rash came back again.  So there is no connection between the sneezing and the rash is it?

A remedy can work, and then after some time the case relapses and you have to repeat the remedy–whether it’s a day, a week or a year later.  The fact that a complaint comes back doesn’t mean that the remedy you gave for it failed or was the wrong remedy.  Relapsing is common.  It’s very rare (except in acutes) that you give a remedy one time and you never have to give it again.

As for your question, “So there is no connection between the sneezing and the rash, is it?”  The concomitant in a case very often has no connection to the complaint at all.  That’s what makes it all the more compelling to prescribe on, because it’s so peculiar!  For example: menstrual cramps with burping.  Why should someone be burping with menstrual cramps?  It makes no sense.  All the more reason to give Carbo veg!

Yes, I was thinking about it.  The prescribing on concomitant symptom is basically prescribing on a peculiar symptom.  I have to keep it in mind.





Oh look, it’s the gang from Slovakia!

Hello Elaine and Shana!

Hello Miroslav and Jitka!

Here are our answers to Shana’s sneezing remedy:

Miroslav thinks Rhus-t: because it is in rubrics sneezing and itchy rash.

“Itchy rash” is too general.  You could at least confine it to “rash on legs”.   That would make for a smaller rubric, right?  “Skin: eruptions, itching” has 169 remedies.  “Legs: eruptions, itching” has 34 remedies.  Big difference, wouldn’t you say?

Jitka votes Natrum mur:

Loud sneezing

I couldn’t find “loud”.  I found “violent sneezing”, maybe that’s the same thing.

Nose – running or blocked nose (coryza); annual (hay fever);

The rubric is “Nose: obstruction, discharge, with”.  She doesn’t have hay fever.  She has a cold with a concomitant rash on her legs which has always responded to Histaminum 30C.

Nose -running or blocked nose (coryza); blocked;

Rash in the bends of limbs

Best regards

Your “quiz mascots” … 🙂

I thought Shana was the quiz mascot!  Anyway, Rhus tox and Nat-mur, two reasonable answers.  So, absent the rash, this case would be hard to prescribe on.  She’s got a runny nose with sneezing–very common, am I right?  What’s peculiar about this case?  It’s got a concomitant rash!  Why do we ask about the concomitant?  Because that’s often the peculiar symptom!  Very often, the concomitant is what decides the remedy!  Take a look at this:

Menstrual cramps with crying–Pulsatilla

Childbirth with crying–Pulsatilla

Chill with crying–Pulsatilla

Fever with crying–Pulsatilla

Now, just as a clarification, we know that Pulsatilla has a certain kind of crying.  It’s soft, pitiful and makes you want to help; unlike Chamomilla which is an angry cry and makes you want to yell “Stop that screaming!!!!”  There’s all kinds of crying and you have to determine which kind it is.  The crying of Ignatia is convulsive and spasmodic, sobbing.  So here, in this case, we have a common cold with a rash that we KNOW from past experience is a HISTAMINUM rash!  Therefore, the remedy is….  Histaminum 30C!

Why even ask about the concomitant if we’re going to ignore it?  We ask because we may be prescribing on it!

Ouch!  You mentioned Histaminum, but we thought it worked only palliatively and the girl needed still something more similar…. 🙁

Sorry if I wasn’t clear that I hadn’t given Histaminum in a year.  The point is, I prescribed for the rash and it cured the cold!  Why?  Because it was the concomitant.  Why Histaminum?  It’s her rash remedy.  The point being that this is why we ask for the concomitant in a case!  It’s not just idle curiosity, it’s often the thing the remedy is based on!  Yes, it may have nothing to do with the cold as it’s not a common cold symptom; but, homeopathically speaking, it was the PECULIAR symptom in the cold, and according to Hahnemann, in aphorism 153 of THE ORGANON, we’re supposed to base our prescription on what’s peculiar in the case–striking/strange/rare and peculiar.  Thanks for voting!


Hi Elaine and Shana!

Oh look, it’s Maria from Greece!

it seems too easy to be true, but, I’ll vote for Histaminum.
If I am wrong i will try again 🙂
Maria, you are a genius!!!!!  Yes, it was easy, and it was Histaminum!


All of you might want to see the “Case-Solving Strategies” section on my website, which is here:

Case-Solving Strategies

And be sure to try and solve this month’s quiz too!  Bye, 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

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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