Clinical Cases

Revisiting: Creeping Sore Throat

Written by Elaine Lewis

Homeopath Elaine Lewis gives the solution to last month’s quiz.



Here is last month’s quiz again along with the answer:


Shana, holy cow, look at the time!

Mom, in case you haven’t noticed, I’m in college; which means I’m very busy.

Is that sooooooooo……Doing what, scanning the internet for the Rolling Stones’ tour schedule?

Mom, you must be positively psychic because look at this!

Do I have to?

Yes, it’s the latest release by The Rolling Stones!

Are these people releasing a new record every five feet? 

Mom, it’s another masterpiece of overall brilliance!  I’m not sure which is better, this or “Doom and Gloom”….

Oy vey!

Anyway, here it is, the latest single by The Rolling Stones!!!!!

Well, Shana, that was reeeeeeeally bad!  But, be that as it may, we have to move on.  Do we have a Death Report?

The song is not bad!!!!!   Oh, and Cleve Duncan of The Penguins died.


OMG!  The group that sang “Earth Angel”?  By the way, the guy in the center of the picture is Johnny Otis.  He had a big record called “Willie And The Hand Jive”.  (“I know a cat named Way-Out Willie, he’s got a real cool chick named Rockin’ Billie….”)


(“Billie and Willie got married last fall, they had a Little Willie Junior and that ain’t all…”) 

Mom, you might want to stop singing now, especially since we’re supposed to be talking about “Earth Angel”, remember?

Yes, Shana, but I like “Willie and the Hand Jive” better!  “Earth Angel” came out in 1954 (once again putting to rest the myth that Elvis Presley “started” rock ‘n’ roll in 1956!)   “Earth Angel” is truly an iconic song because everybody knows it!  It’s one of the most recognizable songs in the world!  It was written partly by Gaynel Hodge–a friend of Daddy’s from the Army.

Gaynel writes to me every once in a while.

Below are The Penguins with Cleve Duncan in front:

Goodbye, Cleve!  RIP!

Do we, by any chance, have a quiz?

I guess so.  They don’t pay me to play records here, oddly enough.  Come to think of it, they don’t pay me to do anything!  I’m going to have to ask Dr. B for a raise!

Who’s the patient this month?

That’s a good question, Shana; because I have failed to come up with a fictitious name for her!  Do you want to try?  Anymore dorm names we haven’t used yet?

Berks Hall.

Fine!  So, this is the case of Berks Hall!  So, Miss Hall is 40 years old.  She came to me complaining of some sort of virus and I told her to fill out the questionnaire, here it is:

1. Describe the complaint

Very sore throat that’s been creeping up on me since last weekend.  Sharp pain when I swallow.  Hurts worse when it’s dry.  Green solid mucus in nose.  As of this morning, I’m also dealing with strong stomach cramps and diarrhea with trembling/fever/chills – that was sudden.

2. Etiology–

Maybe traveling in damp weather?  My roommate is enjoying the exact same health experience right now (although she is dry-coughing and expectorating a lot, I’m not).  We went to Block Island last weekend, which was cold and damp (though gorgeous).  I spent a lot of the time being motion sick from the ferry in bad weather followed by some car rides on not enough sleep.

3. Sensation–

Throat: Sharp pain in back of throat, lump in throat when I swallow.

Slight constant ache in left ear with left ear tinnitus.

Nose: Dry chunks

Belly: Continual cramps in mid-gut, just…ow.  Stool feels like it’s poking me in the anus sharply from the inside out.

4. Appearance–

Well, I don’t look happy, that’s for sure!  And my back is very slumpy.

5. Location–

Throat, nose, and guts.

6. Modalities–

Throat, better: hot liquids, swallowing food.

Throat, worse: cold liquids feel better in the moment but then increase mucus; dry air

Nose, better: warmth (showering), picking.

Nose, worse: lying on left side (right sinus is slightly congested)

Belly, better: slumping over while sitting, pressure in and toward navel on left side of navel.  Belly, worse: uh…life

Everything: better for open air, worse for being in the direct line of the fan

7. Concomitants

I think I covered everything so far.

8. Discharges–

Do we need to talk about the hard green mucus again?  It’s dry.

9. Generals–

I’m sad and whiny and I want/don’t want comfort.

10. The mentals:

I woke myself up making whiny noises this morning.

11. What have you been saying?

Mostly just things like “mmmmmmffffffffffwheeeeeeeeeehhhhhhhhhhh,” and also, “I’ll go make some white rice.”

12. What are you doing?

Moaning and groaning, whining.

13. Describe your thirst and appetite–

I’m thirsty but afraid to drink anything for fear of setting off the angry intestine monsters.  Hot mint tea sounds good.  Maybe hot rice in a bit.  I’m hungry but afraid to eat anything.

14. Fever?

It just happened with the first round of diarrhea but seems to be gone now.  Hot feeling, trembly all over, light sweat, especially on my forehead.

15. Sweating?

See #14. No stain.

16. Odors?

I don’t think so but I definitely have morning breath for sure.

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

I just feel so whiny.

18. Is there a diagnosis?

It seems like some sort of flu/cold thing.

19. Describe your energy–

Quiet, reluctant to move, sleepy, collapsed, whiny, so whiny…sooooo very whiny and morose.



Try _______ 30C in water, 5 succussions before each dose, 4 times a day, if not better by tomorrow, it’s probably not the right remedy.  Let me know.

Dear Elaine,

I took a few sips during the night, woke up with a fever and some more free-flowing nasal mucus.  The diarrhea is gone.

That’s good!

The sore throat is gone, I feel slightly perkier.

I guess this is a striking improvement then.

My neck glands are swollen, and I feel like I got run over by a truck.  But I also feel interested in being out and about, and came to work because I just couldn’t handle the idea of sitting on the couch for one more minute.

OK, keep taking the remedy, you’re not quite over it yet.

I may in fact be rejoining the living.  I haven’t re-dosed the __________________ since this morning when the alarm went off (6:45am), and while I’m still wiped out with swollen neck glands and the slightest computer-strain headache, I think I’m slowly on the mend.  I’m at about 65 – 70% improvement now.


OK everybody, what’s the remedy?  Write to me at [email protected] and let me know!  The answer will be in the December ezine!











Rhus tox-2





And the winner is……Oh wait, the phones are lighting up!  Hello?

Hello Elaine, it’s Vernetta from Montreal.

Hello Vernetta from Montreal!!!!

Here is my answer to the quiz.

Good!  Finally, an answer!  I’ve been sitting here for hours!

I used Robin Murphy’s Repertory.

Rubrics selected:


(1) ailments from sea sickness: cocc. 3

(2) weakness from lack of sleep: cocc. 3

OK, the etiology is going to get you nowhere!  She mentioned an etiology for practically everything!  It was damp, it was cold, there was a ferry ride, there was a car ride, she didn’t sleep, her roommate was sick….did I miss anything?  I’m afraid we’re not going to be able to hang our hat on any of these!

Mental / Emotional: moaning, groaning: cocc. 2

Actually, Vernetta, she said she was “whining”–a lot.  In fact, she said it over and over again….”Whiny, whiny, whiny!”  In fact, she said it was the most striking thing in the case!  Now, you know, if a case has a mental concomitant–and there’s no etiology to hang your hat on–the remedy has got to cover the mental concomitant!  So, look at “Mind: whining”, and then there’s a subrubric: “Constant whining” (in Murphy’s) which is what I would pick.

Generals: weakness from sleeplessness: cocc. 3

weakness from riding, car, boat: cocc. 2

This doesn’t mean anything.  The “weakness” rubric is huge!  Weakness from sleeplessness is normal and weakness from a car ride?  No.  You’re going way far afield trying to justify Cocculus.  You know, when you’re reading a case, it’s like turning over a coconut in your hands looking for the soft spot where it will crack open:  Is it the etiology?  Is it a keynote or keynotes?  Is it something peculiar?  Is it the totality of symptoms?  Where is this case going to crack open????  Should we really be repertorizing every symptom?  That would be like “reading” by looking up the meaning of every single word in each sentence instead of gathering an overall impression!  Where does this case jump out at you?  At what point does one say, “Ohhhhhhh!  Wait a minute, look at this!!!!!!!!!!”

“Whiny” might be your first clue!  What remedy does it make you think of?  And, having thought of that, are there any confirmations for that remedy?  Is there anything else pointing to it?

Remember, we do NOT have a “complete” Repertory (The Complete Repertory not withstanding).  If we had a “complete repertory” where every rubric had every remedy in it that deserved to be there, and every rubric that should be listed WAS listed, then maybe you could literally pick out every symptom in the case, add them all up, and say, “Hey!  Look at this!  Cocculus wins!” 

But we don’t have such a Repertory!  There are remedies missing from rubrics where they ought to be; they’re in the Materia Medica, but not in the Repertory.  There are symptoms for which no rubric exists; like for example, “Sleep agg.”  Where is that?  Or “Sleep amel.”  And many substances have had only minor provings, meaning we know very little about them.  Such remedies will never come out #1 in a repertorization.  Some remedies are in the Repertory but as only a 1 or a 2 when they should be in Bold!  Let’s take “Generals, bathing, hot bathing, amel.”  Mag-phos and Rhus tox are only listed as 2’s when obviously they should be 3’s (in Bold).  And what about “Mind: Responsibility, agg.”  Guess what isn’t there?  Lycopodium, Lachesis, Medorrhinum, Phosphorus…  Calc-carb is only there as a 1.  It means we have to be very discerning when we read a case.  We can’t be literal and just look up every symptom and make a grand totality and say with confidence, “And the winner is… !”  

What kind of case do we have here?  To me, what we have in this instance are keynotes; this is a case where keynotes are going to show us the way, keynotes of a remedy accompanied mostly by common symptoms of illness.  You know what Hahnemann says in Para. 153 of The Organon, right?  That the remedy, above all else, must cover “….the most striking, strange, rare and peculiar” symptoms in the case.  When you see keynotes of a remedy, those are often the strange, rare and peculiar symptoms of which Hahnemann speaks.  Remedy keynotes are almost always “peculiar”.

For example, fever is NOT a keynote of Belladonna; but, HIGH fever with a dry, radiating heat that comes on suddenly, is!  Coughing is NOT a keynote of Spongia; but, a dry cough that sounds like a saw cutting through a pine board, or a seal barking, is!  So, in this case, I see keynotes of a remedy, that’s what jumped out at me!

Locals: back (slumpy), weakness: cocc. 2

stomach, cramping pain: cocc: 3

stomach, cramping pain during fever: cocc. 2

These are mostly common symptoms of a virus and don’t lead us to any remedy in particular.

I suggest cocculus 30c after comparing cocculus in 9 Materia Medicas.

Thanks for those great quizzes and I always look forward to them.

Still?  Even after I disparaged your Cocculus prescription?

Yes, even still!  Thanks for the detailed critique.  I’ve gotten stuck on the “whining” symptom.  My Murphy’s leads me to “complaining and moaning”

My murphy’s says, “Mind: whining”.  I have Murphy’s 3rd edition, do you?  I checked the Complete Repertory, there’s no rubric for “Mind: whining”, which I find surprising.

I don’t seem to have a subrubric of “constant whining”.

“Mind, whining, constant”.  Well, this is a shame!  OK, there are other keynotes of this remedy in the case.  My first clue, to tell you the truth, was, “I want / I don’t want comfort.”

At this moment I think of pulsatilla as she reported that everything was better in open air.

There are 200 remedies in that rubric!  There has to be a better reason to pick Pulsatilla.  You can use “better fresh air” to help confirm your remedy!  If you were thinking the remedy was Pulsatilla and then you saw “better fresh air”, that would support your choice.  Let me give you an idea of just the remedies in BOLD under “better fresh air”: Pulsatilla, Alumina, Argent-nit., Arsenicum, Iodum, Mag-carb., Medorrhinum, Rhus tox, Tuberculinum, etc.  That’s a lot of polychrests that strongly have that symptom.

There was also the contradictory aspect of wanting, not wanting comfort.

OK!  OK!  Now you’re onto something!

Thus I’ll go with pulsatilla.

But that’s not Pulsatilla, Vernetta; Pulsatilla is not of two minds when it comes to wanting comfort, they ALWAYS want comfort, to be comforted, and they’re better for it!  They are easily reassured.  Both Phosphorus and Pulsatilla desire comforting and are better for it.  If you tell them, “It’s OK.  You’re gonna be OK….”  They will believe you!  You can actually make them feel better that way, unlike Arsenicum which WANTS to be comforted but they are never comforted for any length of time, they will not believe you when you say they’re going to be OK; they will ask you over and over again, “Am I going to be OK?  Are you sure I’m going to be OK?”  So, no, you’ll never hear Pulsatilla say, “Gee, I don’t know if I want to be comforted or not….maybe I do, maybe I don’t….”  They always do!

But now remember, we have another big keynote of this same remedy hanging out there, still to be discovered!

Now you have taken me to a whole new level!

I have????

And I’m sooo grateful.  The tattered edition of Murphy’s that I’ve been using is falling apart despite even getting it rebound in India.  I’m addicted to it.  But this experience has taught me a lot and all with your help.  Now best of all, I have another two heavier versions at home….

You have two more Murphy’s at home?

…which I don’t normally use because they are so big.  I found the second edition and lo and behold I found the whining rubric and the subrubric!!

Aha!  So, you mean you have been using Murphy’s 1st ed., which is thinner and less heavy, instead of the 2nd ed. of his Repertory which is thicker and heavier?  I carry the 1st ed. in the trunk of my car, just in case I should ever need a repertory while I’m away from home; but, I have the 3rd ed. here.  Yes, it is much heavier (because more rubrics have been added, meaning it’s more useful)!

Thank you Elaine.  I will be eternally grateful!

I have totally blown this but I’m not giving up, of course.  I’ll get back to it later today but I will do the heavy lifting.  I’ll do the case later today.

Thank you again.  Your analysis is right on and I have been very sloppy and careless.  Using “better from open air ” was a total cop-out on my part.

Don’t get me wrong, that can be an important symptom; but, it doesn’t lead you to a remedy all by itself.  It can help confirm a remedy, though.  And if we had no keynotes in the case, as sometimes happens, then “better open air” would certainly be a part of the totality, you can be sure of that!

Hi Elaine, I’m still at it over this quiz!!!!  Check it out:

Mind , conflict with oneself found it on page 1270: Ignatia-2

Mind, will, contradictory: ignatia- 3

Mind, whining: ign.-2

Mind indecision, irresolution: ign- 3

throat pain, > swallowing food: ign- 2

You did it, Vernetta, you cracked the case!  It is Ignatia!!!!!   Very well done!

What struck me throughout was a contradictory aspect to the symptoms.  For example:

sore throat creeping up meant slow onset, contrasted

with the stomach complaints which she said were sudden;

in the throat area she experienced the sensation of sharpness but also lumpy;

throat > hot liquids but also felt better in the moment from cold!

wanted/didn’t want comfort,

thirsty but afraid to drink, hungry but afraid to eat.

in the recovery phase felt like run over by truck but still wanted to get out and about.

You saw even more Ignatia symptoms than I did!!!!!

Thanks for all your patience throughout this.  I’ve had to keep coming back again and again to the quiz.  I’ll certainly keep you posted on the outcome.  I really appreciated this whole exercise and especially moving on to Murphy’s 2nd edition.

I guess you now see how important that was!

I have a few of the 3rd edition Materia Medicas but at home I have only the first and second editions of the repertories.  I still have another one at my office.  I’ll have to check if it’s the latest or not.  Otherwise I’ll need to schlep a few over from India.

This is the first time the word “schlep” and “India” have ever been used in the same sentence!  Do we have an award for that, Dr. B?


And the winner of the coveted “Schlepping Off To India” award goes to….Vernetta from Montreal!  (applause-applause!!) 

Is there another caller here today?


Hi Elaine!

Hello Maria!!!!

I had to decide among 3 remedies,

Is that soooooooo????

Lach, Rhus-t and Arsenicum


I am sure you are guessing the reasons!

Not really…..

Lachesis seemed more suitable for the throat modalities, except for warmth amelioration which Rhus and Ars fit better.

Etiology: cold-damp weather, Rhus-t is well known for.

Well, Maria, there were so many “etiologies” in the case, I decided to ignore all of them!

Open air amelioration: Ars and Rhus are a 3 and Lachesis is a 2.  Not helpful for my vote battle, I have to admit!

“Moaning-groaning” Ars is a 3, Lachesis is a 2 and Rhus t. is grade-1.

Actually, Maria, she made quite a point of saying she was “Whiny”, and she said it over and over again; plus, she said it was the most striking thing in the case!  We have a rubric in Murphy’s, “Mind: whining, constant whining”.

I eliminated Lachesis mainly because of etiology.

So I am between Arsenicum and Rhus t.  And here comes the struggle!

Etiology fits better Rhus but the intense moaning fits Ars!
Such an intense symptom must be covered from my remedy, but the etiology is better covered from Rhus.  Oh boy, the etiology nigthmare!
So what it will be?

Even I still hate myself for not voting for Ledum in the previous quiz, I will go for Arsenicum because of the intense mentals.  If I am wrong I will try again!

You’re wrong, so try again!  Now, Maria, what did you find that was striking and peculiar in the case, other than the already-mentioned whining?

I looked for the word in lexicon but it wasn’t there.  I guess it is similar to moaning etc.  I found the rubric as you said.  Few remedies with calc-p only in 2 grade.
In first grade are ars, cham, cina, ign, mang, puls.

What striked me more was the cold drinks amelioration.  And then the fan, she has the fan on?  It is not winter there?
I can not think of something else, maybe I missed it.
It is the first time I don’t have any ideas!

Didn’t it strike you as odd that she didn’t know if she did or didn’t want to be comforted?  Like, maybe she did, or, maybe she didn’t?  She seems “conflicted” about that, wouldn’t you say?  And what about the sore throat being better for swallowing food, isn’t that peculiar?  Because normally, food would be an irritant to a sore throat.  And then, looking back on the “constant whining” rubric, does anything jump out at you?

Oh yes I saw that about comfort, but I didn’t understand at all if that was a mistake or something of her writing.  It is odd indeed!

It was no mistake!  That’s what she meant to say!

The amelioration from swallowing food is the reason I thought of lachesis.

Right, but, that’s not the only remedy that has that.

I had this kind of sore throat cured by lachesis so it did not strike me.

The only common remedy between those 2 rubrics is Ignatia.

Yes!!!!!!  It is Ignatia!

Better swallowing food and whining.  The conflict you say, I cannot think what rubric this is.

Mind, conflict, internal

Reminds me though of the contradictory symptoms of ignatia.

Yes, that’s it!  Ignatia is full of contradictions!  Paradoxical symptoms. The opposite of what you’d expect.  See also, “Contradictory and alternating states”.

Ignatia??!!!!  How on earth did you see that coming at first?!!!

It was either “Sore Throat, better swallowing food”; or, “I want /I don’t want comfort”.

I wouldn’t have come up with it even if I repertorized for a million years!

Well, that’s just it, Maria, I don’t think this case repertorizes well at all; the reason being that the Repertory isn’t a perfect reference book, where every rubric that’s supposed to be there IS there, and every remedy appropriate to each rubric is listed!  I am often shocked that certain rubrics that ought to exist, don’t!  And then sometimes I find myself saying things like, “I can’t believe Medorrhinum’s not listed under ‘Lazy’!”  So, what this means is, you can’t always rely on strict repertorization to find the remedy!  You’re always thinking, “Where is this nut going to crack open?  Do I see a peculiar symptom?  Is there a diagnosis?  Do I see keynotes of a remedy?  Is there Sudden Onset?  How should I approach this?”  Sometimes you have to repertorize because there’s no etiology, there are no peculiars, no mentals, no keynotes…. It’s like a toothache where all you can do is repertorize the symptoms and see what comes up:  Worse biting down, better cold drinks, worse pressure, pain left side, pain upper teeth, sharp pain, etc.; that’s all you can do is just do a straight up and down repertorization and give the remedy that comes out on top!  But here, in this case, among a sea of common virus symptoms, we have an image of a remedy—Ignatia!

Thank you for the step by step guidance, that was a very good lesson indeed!

What a great quiz!!!

Thank you, do come again! 

Who’s next?  OMG!  It’s my soul brother from Wales, Peter Dunseith!


Hi Elaine.  When thinking of ailments from cold and damp, it is usually Rhus tox, Dulc, Calc carb or Natrum sulph that come to mind.  In this case only Lachesis has the sensation of a lump in the throat on swallowing, and pain in the throat ameliorated by swallowing food.  Lachesis is aggravated by getting cold and wet, is moaning (whining)

See, that’s the thing, Peter, I don’t think moaning and whining are the same thing.  Moaning is a sound you make when you’re sick.  Whining is an obnoxious tone of voice used in speaking, as in “I don’t waaana go out!  I wanna stay hoooome!”  (Charming, n’est-ce-pas?)

and morose when in pain, has an affinity for throat and GI tract complaints, better from pressure, greenish mucous secretions, aggravated by draft and (surprise) ameliorated by warm drinks.  So I put my dime on Lachesis.

Well, thank goodness you didn’t bet the store!

And thanks Elaine for reminding me of the Penguins.  RIP Cleve.

Thanks, Peter!  You are totally cool!  Dr. B, don’t we have something for Peter?


                       “Earth Angel”.  Perfect! 


Did anybody get the right answer?

Hi Elaine,

Mind; whimpering

Mind; whimpering; waking, on

Hearing; noises; left

Throat; lump sensation; swallowing; agg.

Throat; pain; swallowing; amel.; food, solids

Rectum; pain; stitching; stool; during

Generalities; contradictory and alternating states

IGN (100/6)

NAT – M (73/5)

NUX V (70/5)

I choose IGNATIA ’cause there are so many contradictory symptoms:

” Sharp pain when I swallow” and however “Throat, better: hot liquids, swallowing food.”

“I want/don’t want comfort”

I’m thirsty but afraid to drink”

“I’m hungry but afraid to eat”

And of course she is “sooooo very whiny and morose”



OMG!  That was perfect!!!!  Congratulations!  I couldn’t have said it better!  This was not an easy case!!!!!

Dr. B, do we have any gold stars for Clement?

Very nice!  I want to thank all the people who voted and sent me their rubrics and explanations; I’m sorry I didn’t have time to get to all of you!  Please try again for next time!  Right now, let’s congratulate our brilliant winner, Clement—which I suspect is French, so, say it with a French accent!  See you all back here again in January, when we will be starting our 10th year here at Homeopathy for Everyone!  Oh, and Happy New Year!


Elaine Lewis, DHom, CHom

Elaine takes online cases.  Write to her: [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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