Case Quizes Clinical Cases

Case Quiz #4 – Petr Zacharias

Petr Zacharias, founder of the Prague College of Classical Homeopathy, presents Quiz #4 in his series.

Dear Friends,

I have an ACUTE quiz for you that illustrates the importance of strange, rare and peculiar symptoms. All the information you need is given below. So your goal today is only to find the correct remedy!

So, let´s begin


First interview

It is a case of high fever in a 2 year old boy. The boy started to have high fever at 4 pm suddenly and the fever quickly raised to 39 degrees Celsius. The boy had hot head and cold body and extremities, no appetite, no thirst. I gave Bell without any effect. After 3 hours, I was sure that whole state had remained untouched by the remedy and was progressing further. Then the mother said that, at the beginning of the fever, he had blackish lips and it was at the stage when the fever has not been so high (38.5o Celsius). She said that he always has this symptom during a fever at some stage. After knowing that I gave him a remedy at 3:15 pm and one hour after that, the fever went down to 37.5. The boy started to eat and walk about. Then he went to sleep and the next morning he was totally free of symptoms. What is the remedy?


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


Analysis of the case for students of homeopathy

The most important moment for me was the information about blackish lips. It would not be of great importance in cases of cyanosis where we can expect it but in this case it is very peculiar, especially if we realize that it comes as concomitant whenever this child has a fever. Black or blackish lips is a most characteristic (keynote) for Arsenicum album, and in this case it is a strange, rare and peculiar symptom. If we see a case with high fever, hot head and cold extremities, we often tend to prescribe Belladonna at a first glance, but there are several remedies having this combination as well. The three main remedies are Belladonna, Arnica and Arsenicum but we can find it in others as well.

If all these three has hot head and cold extremities, what is the difference?

In Belladonna all symptoms usually flare up very suddenly and they are very intense. There is strong local congestion in affected parts, intense redness and throbbing. If we see these features together in whatever pathology, we have to keep this remedy in mind. These features are exactly what modifies the diseases and make it Belladonna. Now, if you try to use your imagination and understand how every pathology is modified in this remedy, you will be able to spot and recognize its essence. Imagine for instance tonsillitis. In every tonsillitis we have several symptoms that are quite usual in this condition but what makes it belladonna? The tonsillitis comes up very rapidly, the fever comes suddenly and will be very high (intense). We see the strong congestion of head while the extremities are cold. Strong congestion in affected parts (in this case head and tonsils) that comes very rapidly. Due to this congestion these affected parts are fiery red and patients feels burning and throbbing pains. So in tonsillitis you will see sudden onset of all symptoms (fever, pains, swelling of tonsils), local congestion (hot head, red face, red eyes, very red tonsils) and throbbing pains in tonsils, in head, etc. You see how the remedy colors the broad pathology and makes it unique? This is something we have to understand in every remedy.

Arsenicum album gives us the idea of death as Prof. George Vithoulkas says. We look at the patient and his eyes are sunken, his skin transparent, he has blue rings around eyes, an anxious expression and his lips are black. The patient looks as if dead. Arsenicum album is very chilly but his head is hot and must be uncovered in most of complaints, especially in acutes. You see the difference with Belladonna, as Belladonna looks very vital with red cheeks but the Arsenicum is exactly opposite. There is also a marked difference if we study the effect of fever upon the psyche. If the mental and emotional symptoms are present, Arsenicum (as he tends to be very insecure concerning his health) will be anxious and restless during physical complaints with fear of death. Belladonna can be very aggressive during fever as the meninges are irritated due to the strong congestion (much stronger then in Arsenicum), with biting, strong and intense hallucinations and the desire to jump from bed, escape and hide. Arsenicum is restless and must move, but Belladonna is often aggravated by motion, especially jarring (as it makes the congestion much worse).

The main idea in Arnica is fear and aversion to being touched. This is why in most of complaints he says he is okay and sends the physician away. He does not want to be touched or approached. This is very characteristic and very marked in this remedy, no matter what is the pathological condition. It is connected to its essence. Now this remedy also has hot head and cold extremities in fever but we also see a peculiar comma like delirium. The patient looks unconscious, but when we ask him something, he answers correctly and then falls back into stupor. If this condition is the result of sepsis or a blow to the head then we have to take this remedy into consideration even more. And when any of the discharges smell or taste like rotten eggs, then we could be quite sure of this remedy.

The remedy prescribed to this patient was Arsenicum album 200 in one single dose.

Hope you enjoyed it 🙂



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.


  • OK….So, Arsenicum is in bold for black discoloration of the lips. I also repertorized “sudden onset” of complaints, fever at 4 pm, thirstless during fever and hot head/cold extremities during fever, and Arsenicum comes up in first place, slightly edging out Belladonna.

Leave a Comment