Case Quizes Clinical Cases

Revisiting: Constant Spitting With Sore Throat

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Revisiting: Constant Spitting With Sore Throat. Did you guess the right remedy?

To read last month’s full case quiz. Visit – Constant Spitting With Sore Throat


Rhus tox-3



Hepar sulph.


Not too many answers this time, where did everybody go???? Hello!!!!

Hi Elaine,

Please let me try again if i am wrong. The rubrics-

> 1. Throat, pharyngitis- Sil-3,lac-c-2, phyt-2, merc-1
> 2. Throat pain- on swallowing- empty agg- merc-2, lac-c-2, phyt-1,
> 3. Mouth-spitting constantly- merc-3
> 4. Mouth -spitting must- merc-2
> 5. Aggravation time-2.a.m- merc-2
> 6. Nose- yellowish green discharge- merc-3

Merc sol would be the remedy. It has red spots, it is thirsty.
Two red spots on both the cheeks is the key, i know.

Aha! You did know! Well, then, Monika, you knew all you needed to know!

But i couldn’t find an exact rubric.

Here it is, in Murphy’s repertory: “Face, acne, symmetrical distribution”. The operant concept here being “symmetrical”, and you’ll see there is only one remedy–ARNICA! Case closed! You know when we take a case, if a peculiar symptom pops up, we’re done! It’s like the tonsilitis quiz we had here when the child was eating butter off the stick? Pulsatilla! Case closed! When we’re taking a case, we hope to find one of these–a strange, rare or peculiar symptom that’s going to make everything else irrelevant, and look at what else you have anyway! All common symptoms, completely worthless! The spitting? He was only spitting because of pain on swallowing! Arnica has symmetrical eruptions, when you see a super-keynote of a remedy in a case, throw everything else out and give the remedy! That’s our lesson for today.  I knew people would pick Mercury but he did not have excessive salivation, he had throat: pain on swallowing.

Is anyone else here today?

Hi Elaine, tough quiz this month.

It must be, nobody’s answering it!

I am between Belladonna and Mercury.

I knew people were going to pick Mercury!

The thirstless rubric worries me, but I can’t come up with another remedy.

The onset is sudden, the red cheeks, it could be Belladonna.

Except, the red cheeks are more like eruptions, the size of dimes, and they’re perfectly symmetrical, mirror images of each other.

It is under 1 grade in rubric “must spit” whereas mercury is a 2.

Yes, Belladonna does spit, but it’s mostly a psychological problem. Here our patient’s throat hurts, so he’s spitting in order to keep from having to swallow. It’s different.


So I will vote for mercury. If I am wrong, you already know my second vote 🙂

If it is also wrong, I will come up with a 3rd remedy, and a 4th and a 5th etc.

OK, Maria, here’s the thing, remember last month’s quiz answer when I said there was too much emphasis on symptoms and not enough emphasis on the context they were occurring in? Why is Maurie Amsterdam spitting? Is it because of the “excessive salivation” that Mercury is famous for? Or is it because he has a sore throat and can’t swallow? If he’s spitting because he has a sore throat and can’t swallow, then spitting is not a symptom! Possible rubrics might be:

Throat, pain, swallowing, difficult

Throat, pain, swallowing, on, empty, agg.

Throat, pain, swallowing, liquids, amel. (because he was able to swallow water, remember?)

However, even having said all that, why is it irrelevant? Because there’s a PECULIAR symptom in the case–peculiar to a certain remedy! Remember our “hierarchy of symptoms”? (See my article, “Acute vs. Chronic Remedies, the Hierarchy of Symptoms, and the Kitchen Sink”)

Here is the hierarchy of symptoms:

Etiology (meaning, “Ailments From” or “Never Well Since…”)

State, or diagnosis. In other words, “What’s wrong?”

Onset–sudden or gradual

Delusions or Strange/Rare/Peculiar symptoms



Physical Generals

Local Symptoms

So, we’ve got ourselves a Strange/Rare/Peculiar here! That’s going to trump all the local symptoms at the bottom of the hierarchy, we can just throw them all out!

So, Maria, as you might have guessed at this point, the peculiar symptom in this case is…..

the symmetrical red spots on both of his cheeks! The only way to find this symptom is go to:

“Face, acne, symmetrical distribution”. The idea here is symmetry of eruptions. And the winner is…..?

NO WAY!!!!  Arnica????


You see I searched a lot for the symmetry but I thought it was discoloration, like flushes of heat, as we get red cheeks when we are shy. I didn’t think of it as eruption. And I did not find anything.

They were just “spots”. That’s all the father said, red spots, the size of a dime. This is a dime, and roughly the exact size, maybe a little bigger, but it gives you an idea:

Revisiting: Constant Spitting With Sore Throat 1

So a red spot on both cheeks in the same place, that size, would be quite noticeable and quite peculiar!

My selection -ok it has some weakness- is a 2 under “pain, empty swallowing” and a 3 in amelioration from liquids.

So I thought if he can drink water he can swallow saliva, so it must be excessive salivation for spitting that much.

But Arnica??? It is not even in any of these rubrics. How on earth did you find it???

This is why we ask for “concomitants”, Maria. For a concomitant to be valuable, it should have nothing or almost nothing to do with the case, like menstrual cramps with burping, which might tell us that the remedy is Carbo veg. In this case, the two red spots were concomitant to the sore throat. Concomitant means “along with”. “What came along with the complaint?” Answer: “These two red spots.” “Are they mirror images of each other?” “Yes.” We’re done! Good-bye! Nothing else matters! Because it’s a super- keynote of a remedy, and it’s “peculiar”. Homeopathy is not always a matter of listing all the symptoms in a case and repertorizing them, adding them up, so to speak. Sometimes there are “short-cuts”! I wrote an article about that called, “Get A Clue: Who Is Guilty of Disordering This Patient?”

It’s like you’re busy adding up the symptoms of the case, just the way you were taught to do, and then all of a sudden the patient blurts out, “When I walk outside, I’m afraid the buildings on either side of the street are going to fall on me.” Is there any point in going on after that? Is there anything else you need to know? Is the case over now? Can you stop repertorizing? Yes!!!!!! Why? You just heard a super-keynote of Argent-nit that probably no other remedy has, plus it’s a delusion, and it’s a mental, and it’s Peculiar. The triple-crown! That’s it, you’re done, take the rest of the day off!

You know that “Kitchen Sink” article you mentioned, I have read it hundreds of times! I have printed it out and keep reading it again and again. Well, I wouldn’t have found Arnica even if I kept guessing for months 🙂

When Maurie Amsterdam’s father said there were two red spots on his son’s cheeks, I said to myself, “Please let them be symmetrical, please let them be symmetrical, please, please, please!”

Arnica is a 3 under Skin/eruptions/symmetrical.

Really? Which repertory?

Vithoulkas’ compass. He has a beta software on-line with a repertory in it. Here is the link

You just register with your mail and then you can use it free. It is like his Radar software, except it’s only online and free.

Murphy has this rubric too but I see Vithoulkas has upgraded Arnica to a 3! That’s great! Thanks for the link!

It is here too

If people have learned nothing else here today, it’s that Arnica has symmetrical eruptions!

Is there anyone else here?  I’ll take the next person in line?

Hi, this is my first case quiz that I dare to write you, even though I have been reading them long time ago.


I would give this patient Rhus-Tox.
The symptoms I choose were:
Nose – Discharge – Yellowish green
Mind – Spitting
Throat – Pain – Swallowing – empty – agg
Face – Discoloration – red – spots

This 4 symptoms give me: Merc, Ars, Calc, Lyc, and Rhus-Tox
*Note: If I use the symtom Face – discoloration – red – spots – cheeks the only remedy that covers all of them is Rhus – Tox,

Hope to read the answer soon
Att. Dr. Javier Chiriboga from Ecuador

Thanks for voting, Dr. Javier from Ecuador! Now, first of all, you can’t use “Mind, spitting” because this is what crazy people do, and the reason “Maurie Amsterdam” is spitting is only because he has a sore throat and it hurts to swallow. What this means is, spitting isn’t even a symptom in this case! The symptoms are as you say–painful empty swallowing, the discharge from the nose and the all-important RED SPOTS! And what do we know about these red spots? They are SYMMETRICAL! So, we’ve got a peculiar symptom here that’s covered by virtually only one remedy and that is (ta-da!) ARNICA! Arnica has symmetrical eruptions. You know about paragraph 153 of The Organon, right? Where Hahnemann says, essentially, that if there’s a strange, rare or peculiar symptom in the case, the remedy has to cover it, forget everything else! So that’s why our remedy here is Arnica and not Rhus tox.

Thanks for coming out of the closet!

Dr. B, nobody won!

Revisiting: Constant Spitting With Sore Throat 2

Don’t worry, Elaine, someone is bound to get the gold star in May!

I suppose you’re right…. See you back here again next month!

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

About the author

Shana Lewis

Shana Lewis

Shana spices up the Hpathy Quiz with her timely announcements and reviews on the latest in pop culture. Her vast knowledge of music before her time has inspired the nickname: "Shanapedia"!

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