Clinical Cases

Melvin Kravitz Is A Kali Carb!

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Elaine Lewis treats a horrifying rash, and we all learn some lessons in prescribing.

Dear Elaine,

I have been reading your column for months now and am quite grateful.  The “Aggravation Zapper” has been a lifesaver for us.

I’m currently dealing with illness running through the house.  Most of it is resolving just fine, but my husband has, in the wake of a fever, broken out with an extremely painful rash on his skin which is quite debilitating.

What would be involved in a consultation?

Mrs. Melvin Kravitz

Hi Mrs. Kravitz, thanks for your interest in my column!  Yes, sure, here is the questionnaire:

Thanks, Elaine; attached is a photo of the rash.

We’ll get the questionnaire filled out ASAP.


Name: Melvin Kravitz (not his real name)

Age: 35

Male or Female: Male

Weight: 320 lb.

Height: 5’7″

Date: 02/28/2013

Email Address:

1. Describe the complaint or complaints in your own words in as much detail as you can.

The complaint is a rash on the left shin that is causing excruciating pain making walking nearly impossible.  Sitting and standing are very difficult.  It is hot to the touch (surrounding skin is fairly cool but the rashy area is burning up) with a general pink/red area and small, raised, pimple-like bumps that may have fluid.  The skin is very shiny.  It is not at all itchy.  There is a revulsion to touching it.  When walking, he fears that his shin bone is going to snap.  The whole area of the shin, from below the knee to the ankle, hurts when walking.  When touched, it has a pinching pain similar to pain when touching a bruise.  Earlier, he described it as feeling like it had been whacked by a 2×4 or aluminum baseball bat.

Which brings us to onset.  No blunt force trauma was involved, despite the feeling of bruising.  A rash first appeared in early February in the wake of a bout of flu.  The fever was treated with homeopathy and resolved fairly quickly, but two rashes appeared on the left leg.  One on the upper calf had some very impressive blisters which eventually ruptured, scabbed over, and are on their way to being healed.  The other was a small red patch on the shin which also appeared to be healing.  On Monday of this week, I picked Melvin up from his workplace in the afternoon.  He had felt an illness coming on all day, had chills and body aches and couldn’t keep his thoughts together.  By the time we got home, he was running a fever of 101.8.  There was enough clear indications of Arsenicum Album that I gave it to him and the fever broke by 3 am.  (Again, thank you for the Aggravation Zapper.  I only had 200c on hand and it was way too potent.)  By Tuesday morning, he was considering going back to work for the afternoon but was overcome by sleepiness.  By evening, the rash on his shin had come back and was beginning to become quite painful.

2. Etiology–this means the CAUSE.

Unknown.  It appears to be a result of or related to the fever.  This is now the third time in the last year that a fever has resulted in crippling leg pain and rash.  Once, following Easter last year (high fever -> rash outbreak on right foot with much weeping, oozing, and pain that is only now resolving).  The second four weeks ago, and now this one, both of which manifest high fever -> rash outbreak on left shin and calf with debilitating pain and severely limited mobility.

The incident four weeks ago seemed to resolve itself best with four days of bed rest.  We couldn’t find a remedy that made any noticeable difference.

As to source of fever, no idea as there’s too many possibilities (change in weather, cleaning out a dusty office, etc.).  It does appear to be fairly contagious though as the whole house is down with an upper respiratory illness.  (There are myself, Melvin, and four of our five kids all sick.)

3. Sensation–describe the pain or other feeling you have.

Its a dull ache like a bruise with a fiery sensation on top.  On sitting or standing its tight like pulling from the knee down to the ankle and feels as if the bone is going to snap outward from the stress.  Once standing, there are 3-5 seconds of excruciating, blinding pain, still localized to the shin area that feels like hot fluid rushing in.  It makes the area feel even more tight and bone feel under even more pressure.  Once walking, initial steps are like an infants, like learning to walk again.  Once moving, pain lessens back to a dull ache like a bruise with fiery sensation on top.

4. Appearance– anything remarkable?

Rash: Pink/red splotchy area about 4″x2.5″, small pimple-like bumps within the general redness

Overall, he’s looking worn out.

5. Location–where on the body is your complaint located?

Left shin

6. Modalities–(What makes your complaint better or worse?)

It feels better in warm shower.  Less pain through the middle of the day.  Greater pain on waking and when tired, especially evening.  Pressure makes it feel worse, as does sitting or standing, active use of the muscles in the leg.  When he coughs or blows his nose, it feels like its pulling the muscles down in the shin.

Standing outside in direct sunshine felt very good.

Warm beverages ameliorate the concomitant cough.

7. Concomitants (other symptoms that are “along for the ride”)

Edema of the entire left leg below the knee including the foot.  No corresponding edema in the other leg or else where.

A dry, hacking, non-productive cough, high up in the chest and lower throat.  The cough itself is not painful but the back muscles are getting tired from it, and it effects the pain in the leg.  Sometimes causes brief, explosive headache and loss of vision (both of which resolve without intervention within moments).

Raw throat from coughing and post-nasal drip.

8. Discharges–color, odor, consistency and sensation.

None from the rash.  Sputum from cough is moderately thick, clear with streaks of yellow.

9. Generals–these are all the symptoms that begin with the word “I”.

Cold, except for the feet, Tired, Restless, Thirsty but doesn’t want to drink, Sensitive to light and sound, Can’t focus, Doesn’t want to be touched (This last is very unusual for him)

10. The mentals: Is the complaint changing you mentally and emotionally?

Feeling cranky and reclusive, Doesn’t want to be touched or socialize, embarrased by the amount of help he needs to perform basic life functions, fearful of the leg breaking, fearful of gangrene and amputation, feels indecisive, jumpy, difficulty staying focused on work.

11. What have you been saying?

Lots of language unfit for print.  Also “Just shoot me now.”

12. What are you doing?

Grunting, groaning, growling, snarling, weeping when trying to sit, stand, or move while recumbent.

13. Describe your thirst and appetite.

Appetite is depressed.  Feels thirsty but needs to compel himself to drink.  Aversion to cold drinks (they exacerbate the cough).  Craving soda.  (Can’t drink it, because allergic to High Fructose Corn Syrup, but cold, fizzy, and sweet sounded good.)  Doesn’t want wine or liquor.  (This is also highly unusual.)

14. Fever?

Not since Tuesday morning as a general thing.  Rash seems to be feverish, though.  It’s constant and dry.

15. Sweating?

None of note.  (This too, rather unusual since he tends to run warm.)

16. Odors?

No idea.  No odors from the rash.  My sense of smell is off at the moment and he is convinced that he always smells bad.

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

“I can’t use my leg.”

18. Is there a diagnosis?

We have not seen a physician.

19. Describe your energy.

Tired, restless

20. What does your tongue look like?

Coated with yellowish-gray, clean and pink at tip and edges


Elaine’s Comments:

The first thing I notice is that as long the fever is there, there’s no rash.  And it’s interesting that she says, “The rash feels feverish”!  It’s as though every time she’s treated a fever of his, it seems to “relocate” to his leg as a “fiery” rash.  (So, all of you out there with “fever-phobia”, look at how dangerous it can be to interfere with a fever!  The body doesn’t seem to like it at all!)  You might consider the possibility that fever is protective and maybe our “knowledge” about fever is completely wrong.  I asked Mrs. Kravitz what the problem was with drinking if he was so thirsty.  She said it was only cold drinks.  They make the cough worse.  Warm drinks were fine.  I asked what remedy she gave to stop the fever.  She said Arsenicum 200C.  I said, “How did you know it was Arsenicum?” She said:

He was shivering, cold, dreaming of hot cocoa.  If we had a working fireplace, he would have been right by it.  As it was, he had the heating blanket on and it wasn’t enough.  He was suspicious when I gave him the remedy in a water bottle.  He wanted my company and didn’t want me to leave.  All the upper respiratory complaints, the cold, and the fear of “What on earth is she giving me?” suggested Arsenicum.

I’m wondering if he may be “proving” it?  (And by “proving it”, I mean, overdosing on the remedy and taking on the characteristics of it; for example, when you’re “drunk”, you’re “proving” alcohol.)  I just looked Arsenicum up in Murphy’s Materia Medica and under the “skin” section I found:

Pimples, vesicles, burning violently. Epithelioma. Urticaria with burning and restlessness. Malignant pustules. Anthrax.

Is the rash ameliorated by hot applications?  (This was a very important question for me!!!!  If the answer was yes, I would have the information I needed!  “Burning pains, better by heat” only lists 5 remedies, and Arsenicum is the main one!  I got my answer: Yes!)

“Mrs. Kravitz,” I said, “I have to say that it still looks like Arsenicum to me: burning pains, better by heat.  Excoriating discharges.  Chilliness.  Fear of disease, despair of recovery. Cough worse cold drinks.  Restless.  Better warm drinks.  Try a “zapping” dose of Arsenicum 200C in the 12th cup.”

Now, for you listeners out there, when I say “a zapping dose of Arsenicum in the 12th cup”, here’s what I mean:

How to zap an aggravation

See article, “The Aggravation Zapper“.  But here is the “Cliff Notes” version:

1. Stand at the sink

2. Turn on the cold water full blast.

3. Fill up a medium-to-large disposable cup with water.

4. Drop in a pellet of the remedy that aggravated (if the remedy was in a water bottle, make it a drop or as close to a drop of water as possible and drop it in the cup). The pellet doesn’t have to melt.

5. Wait a couple of seconds, then dump the cup out in the sink. Yes, the pellet will be dumped out too!

6. Refill with water.

7. Dump out again.

8. Refill with water.

9. Dump out again.

10. Keep doing this dumping and refilling.

11. Stop at the 12th cup and take a sip.

12. Wait an hour. It should work by then. It may work right away.  While you’re waiting, you can read the full article.

I’ll go ahead and put the zapping dose together, Elaine.  What should I be looking for in terms of improvement?

A feeling of relaxation, Mrs. Kravitz; less anxiety, a lessening of pain.  Don’t expect the rash to go away!  In fact, it may go away last!  The body heals the most limiting symptoms first; so, high on the list would be mental symptoms and pain!  At the bottom of the list would be a painless rash.  So, all we really want to see is that the case is moving and moving forward.  Movement is all we’re interested in.  As long as the case is moving, we don’t have to redose.

And what time frame?

Look for some indication in an hour, hopefully…..

Did you read “The Aggravation Zapper”?  Diane gives examples of what one can expect.


Elaine, I gave the aggravation zapper at around 2 am last night.  At 7 am this morning, the mentals have changed for the better and the pain is significantly less, uncomfortable but not debilitating.  He is cheerful, tired but not exhausted, and seems to have slept well.  No longer chilly.  He says that not having the sensation of the leg being about to break is fantastic, and cold grape juice and Perrier sounds really appealing.  Pain from the rash is at about 30% of previous pain.  Can stand and walk.  No longer saying, “Just shoot me”.  The cough and rash are still there.

I will continue to monitor the symptoms and see where the rash goes.  Hopefully, we’ll see improvement.

So, here’s what you do now, Mrs. K: You take the antidoting cup (that’s Arsenicum 200C in the 12th cup) and you take a new small bottle of spring water and pour a fourth of the bottle out. Now, add a bit of the zapping cup into the new bottle, let’s say roughly a swallow’s worth.  Shake it up.  Now you have a permanent bottle of Arsenicum 200C/12th cup.  Now he can carry this bottle with him and every time he starts to relapse, he can succuss the bottle 5 times and take a sip.  (“Succuss” means pounding the bottle into your opposite palm.)  I would just caution him to keep the bottle away from electronics, like computer screens, etc.  Maybe he can keep it in an out-of-the-way place, like a desk drawer.

Two days later:

Good afternoon, Elaine.  After the last dose of the aggravation zapper last night, I think the case turned a corner.  He was sweating all night without relief.  The cough has changed.  It’s no longer a cough in the sense of bronchial spasms and is more like a hacking and choking and hawking of much thick clumpy mucus, both clear and yellow, a result of post nasal drip.  He has a very stuffy head with a feeling like the brain is too big and the head will split open, the eyeballs pop out.  Some of that was relieved by a hot shower.  He’s cold, and very sleepy.  Very sensitive, especially to touching the raised parts of the rash.  He said he had a feeling like he had swallowed a splinter in his throat. He asked me to close the blinds because the small eye pillow he has covering his eyes was too much pressure.  Edema is reduced from last night but still present.  Still better on the walking and burning pain.

You can try a dose of Hepar sulph. 30C.  Hepar sweats without relief, is cold; it has very sensitive eruptions and has a splinter-like sensation in the throat.

I’ll see how the Hepar sulph 30C does.

Two days later:

Hi Elaine,

I just wanted to update you on how this had resolved.  The Hepar Sulph 30c seems to have been a bullseye.  Once he had it, the cough rapidly diminished, the rash pain almost disappeared, and the edema has slowly been reducing.  We’ve redosed a few times as pain has returned, but the overall progress is quite positive.  I’m expecting that he should be back to full health by the end of the week.  Many thanks for your help. Here’s an “after” picture of the rash:

Yes, this looks a lot better!

Two days later:

Hi Elaine.  Just wanted to show progress on rash.  Also to let you know that we got the next piece of the puzzle solved.  After about two days of gathering evidence (headache pain over left eye, aggravation of cough between 2-4 in the morning, plus a few other symptoms), I picked up Kali Carb. 30c.  Bullseye.  Swelling is down, not painful to the touch anymore.  Cough and headache disappear almost completely, mentals (feelings of inadequacy & uselessness) resolve.  Yay!  I think this should finish this thing.


Mrs. Kravitz

Oh, yeah, it’s hardly noticeable!

Now, people, I hope you have learned an important lesson here today, namely that using these physical cases as mere stepping stones to the constitutional remedy and not worth solving in and of themselves (as if the constitutional remedy will cure all acute diseases) is just wrong, completely misguided and inappropriate.  Ironically, the constitutional remedy WAS found–but at the end, right where you’d expect to find it, according to Hering’s Law of Cure (“Healing takes place in reverse order.”)  What we did here was prescribe on the presenting symptoms and changed remedies as the picture changed and so when the constitutional layer was exposed at the end, it was easy to see it! 

Melvin Kravitz is a Kali carb!


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

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

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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


  • kudos to Dr. I am finding that Kali carb, as a constitutional medicine in this case. what made you to give hepar sulphur in this case. will you kindly explain

  • It’s explained clearly right in the case. You must not have read it carefully. Go back and read it again. Splinter sensation in the throat, sweating that doesn’t relieve, chilliness, painfully sensitive eruptions….it’s all there.

  • All potashes create weakness amounting to paresis sort of profound prostration but without fever as there is lack of vital heat plus pulse always soft weak,TF Allen.Kali Carb anemic with yellow puffy face longing for sugar and acids has constant fear in mind of his illness sad longs for society arms esp weak sleepy,dread of open dry cold air catches cold and headache worse morning better by sun heat,has feeling of coldness inactivity bowels burning acidity rises up,dry hair vagotonic lungs stitch pains,body self defense creates temperature a boon to fight with disease force and old era homeopaths say up to 102 degree avoid paracetamole type drugs.Fear of disease in Kali Carb type mind says TF Allen is prone to uterine atony and increased tissue wastage.

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