Case Quizes Clinical Cases

Revisiting: Deep Cracks

Elaine gives the answer to last month’s quiz! Revisiting: Deep Cracks

Hello everybody, and welcome to the Hpathy Quiz!!!  And now, heeeeeere’s Shana!

Mom, I have nothing to say.

What???  Well that’s just great!

Except that James Taylor’s new album is coming out in June!

Um….don’t look now, but, no one cares! 

And did I mention that James Taylor will be at the Borgata August 1st?  Tickets go on sale April 24th.


And now for this month’s quiz, featuring the ever-popular Joe Schmo.  (You gotta Borgata!)



Name: Joe Schmo (not his real name)

Age: 66

Male or Female: Male


Height: 6’ 2”

Date: 3/27/2015

Email Address:

  1. Describe the complaint.

My hands break out, crack, bleed, dried-out white skin on fingers, and on my hands. This came on gradually. At one point this was on my toes also. Deep cracks on my fingertips with deep cracking. My skin and fingernails are very thin and they break or peel easily. This has been going on for about 15 years.

  1. Etiology–

We believe the cause of the complaint is from continued working and exposure to rubber and chemicals. It occurred while working at a nuclear energy plant. I was working with petro-chemicals with occasional direct contact to my skin. We believe the rubber and plastic to be the main source of the problem. I went through allergy testing and it said plastic/petroleum problems were the problem. I have been retired for over a year and have not had any exposure to these chemicals but I still have the complaint.

My hands are dried and more severe in the winter. Emotions do not affect this complaint.

3. Sensation–

When I apply moisturizing products such as vanicream, my hands itch like crazy. It isn’t really painful on a daily basis but there is great pain associated with my fingertips splitting open.

  1. Appearance–

I think this was described earlier. I do have droopiness in my eyes but I do not know what it is associated with this.

  1. Location–

Hands and feet.

  1. Modalities–

It feels better when I scratch it but then it becomes worse. If I wear any gloves the complaint becomes worse. It is better in warm weather. If I apply moisture right after the shower it seems to be better for about an hour.

It feels worse if I wash my hands often. Hot water seems to dry my hands out more. This is a chronic pain so there isn’t really anything I can do to make it better. I have tried several ointments, vani-cream, lotions, etc. Nothing has helped.

7. Concomitants

I have ringing in my ears that I have had for years. I don’t think any other symptoms are associated with this.

  1. Discharges–

My fingers bleed when they crack. It will bleed for about 30 minutes. No other discharge comes out.

  1. Generals–

I feel that I have an average, good body temperature. I tend to be chilly more than hot. I do not feel abnormally tired or thirsty. I am retired so I do take a nap every day. I do startle easily especially from loud noises. I tend to be left alone. I am definitely more of a private person.

I LOVE sugar and candy. I crave them often. I do not eat a lot of it but I like a little bit of it every day. I like to drink coffee and milk every day. I also like salty foods like potato chips.

  1. The mentals:

I do not feel this complaint has changed my mood but it has been going on for so long that it is hard to remember if anything changed in the beginning.

  1. What have you been saying?

This has been going on for a long time.

12. What are you doing?
again this is a chronic issue.

  1. Describe your thirst and appetite–

I do not drink very much during the day. On a typical day I drink 2-3 cups of coffee and a glass of milk. I drink a glass of water in the afternoon. I sometimes have a beer at night. I like my coffee hot and my milk cold. I can drink water at any temp.

Typical day of food:

Breakfast: Toast with peanut butter

Snacks: I don’t usually snack

Lunch: Hamburger or sandwich (peanut butter, egg salad, chicken salad, ham), chips, milk

Dinner: Meat, potato, veggie, bread – favorite meat: chicken, I like all potatoes & French fries– veggie- corn, broccoli, asparagus – favorite fruit: apples or pineapples

I like my food hot

  1. Fever?

No fever

We will add a few things to the bottom because it is a chronic condition:

The onset was really gradual. It has been going on for a long time.

I do not sleep very well. I have a C-PAP machine. I sleep for about 5 hours per night. I wake up to go to the bathroom after about 4 hours. I like to sleep with blankets. I do not like to be cold when I sleep. I like to lie flat.

I do not get enough exercise. I need to work on this.

Who I am : I like to read A LOT! I like sports and history. I am very intrigued by science, national geographic, hunting channels. I like to go for drives through the country and I enjoy wildlife. I like to have a certain order to my day and in my life. (not to the point that I am anal about it)


I told Joe to take ___________6C in water with five succussions before each dose/sip, three times a day.  By the way, this is Joe’s first time using homeopathy.  Why a 6C?  This is a chronic case.  As Hahnemann says in the Organon, Aph. 279, “…the dose of the highly potentized homeopathic remedy…can, as a rule, not be made so small that it is not stronger than the natural disease, that it cannot at least partially overcome it, that it cannot at least partially extinguish it in the feelings of the vital principle, that it cannot start the process of cure.”  In other words, it’s enough to just start, make modest, consistent steps.  You don’t have to aim for the outfield in one day after it’s been in existence for 15 years!  However, even having said that, two days after Joe started the remedy, his wife wrote the following:

In a message dated 4/10/2015 8:15:11 A.M. Eastern Daylight Time, **** writes:

Good Morning,

He said he has zero pain.  We both thought that they looked better last night and even better this morning.  Amazing!!  We were talking and thinking that he has had this for 15-20 years!!  He has been to multiple dermatologists, the Mayo Clinic in Rochester, and the VA hospital in Minneapolis and none of them knew what it was.

Second update:

In a message dated 4/13/2015 8:12:13 A.M. Eastern Daylight Time, ***** writes:

Good Morning,

It even looks better today.

Third update:

In a message dated 4/16/2015 8:08:42 A.M. Eastern Daylight Time, **** writes:

Good Morning

I believe it is still improving.  They haven’t cracked open since he started taking this.

So, here’s someone new to homeopathy, and, needless to say, the last thing I want to do is make homeopathy look bad, so, I have no aggravation to apologize for, no proving symptoms to make excuses for, because all he’s getting is improvement, on just a 6C in water with 5 succussions before each dose, three times a day…what can I say?  (I also told him, “As you get better, take less often.”)

The idea of starting every case with a 200C?  Why are we doing that?  Does it make any sense?  It’s 33 times stronger than what was needed!  When giving a high potency and waiting, we risk it being antidoted by mint and coffee and other normal things that people do, we have to wait a month for results, we risk having the case getting worse before it gets better and possibly losing the client!

This guy is gonna tell everyone how great homeopathy is!  Isn’t that what we’re shooting for?

So what do you think the remedy for this month’s quiz is?   See our votes below.






Well, it’s like good news and bad news: The bad news is that not a lot of people voted for some reason.  Was the quiz too hard?  But the good news is, out of those who did vote, the majority were right, it was Petroleum! 

Wafee Abdul Samad said:

Petroleum.  Kent says it is one of the abused remedies.

I wonder what that means?

I considered the contact ailments with chemicals ( petrol); also considering rubrics like: fingers, chapped tips, fissures, cracks (2); Cracks deep, bloody (3); Ear, noises, ringing (3); Skin agg winter (2); Skin dry (3); Nails, skin around dry cracked (1); Frightened (startle) easily (2). Petroleum also lacks heat. I searched for heavy lids or drooping eyes and found nothing but in Allen’s there is weakness in the eyes, and easily fatigued, but here again he is not sure when do some of his complaints start, so I am not sure if it is a concomitant.

Thank you Wafee, good job!  Is anybody else here?  Oh, look, It’s Natalie!

Well, again, it seemed a bit too obvious since he reveals what he feels brought on his condition (petrol products)…

and Petroleum appeared to fit, but when I added all symptoms, the repertory puts Sulphur on top??…(not totally shocked, because the first thing that came to mind as I started to read it WAS Sulphur, but then I felt he gave the ultimate clue by telling what he believes brought it on.

I used the following:

Respiration arrested on falling asleep (he mentioned a C-pap)

Ear noises; ringing

Locomotor; Extremities, Feet, toes; cracks in skin

Desires sweets

Desires coffee

Desires milk (cold)

Desires food warm

Extremities cracks deep bleeding

Sleep flat on back

Eyes, eyelids/margins drooping

Modalities better warm weather

Modalities worse washing

He admits to not exercising (loafs, too lazy to arouse himself) and having to get up at night to urinate (both Sulphur)

SO, despite my gut feeling about the Petroleum… I guess I will go with SULPHUR…Loving the quizzes!– Natalie

Well, Natalie, you were right about the case being obvious, and the answer was Petroleum!  And why?  Because, all together now:  Etiology over-rules symptomatology!

What you found in Sulphur was his possible constitutional remedy (hey, thanks for that!) but when you know what the cause of something is, that is most likely the cure!  (Now we can see if Sulphur gets rid of the rest of his problems!)

Is anybody else here?

Hi Elaine,
Another month has passed — already.
I believe this month’s remedy is Petroleum.

I believe you are right!

I think Joe Schmo has absorbed the chemicals and these are still in his system.
Petroleum according to the like cures like sounds to be the right remedy.  It has ringing in the ears, worse in the wet and winter and cracks and bleeding in the hands.
Like Kent says this is a good remedy where there is inability to throw out eruptions of the skin or conditions in which an eruption has disappeared without improvement to health.
I think one day you should publish “Elaine’s Tidbits”.  Such a lot of good information.

Someday Dr. B will, I’m sure, put my articles in a book.  Thanks for mentioning it, though!

Good Luck,
Wayne Butcher

Oh look, everybody, it’s Miroslav and Jitka!

Dear Elaine,

above all, please accept my heartfelt condolences on the loss of your friend – singer Ben E. King.

Thanks, Jitka!  It did come as a horrifying, unexpected shock!  I guess you saw it on Facebook.

Here are our regular contributions to the quiz.

Miroslav votes- Lycopodium

At first I was thinking about Petroleum, but eruptions in this case would be likely more moist, purulent, crusts would be formed and moreover eruptions would appear also on genitals and a hair skin .

But the case points out to a homeopathic remedy from the Silicea family since this is a man who likes sweets, is intellectually oriented, his nails are brittle and fragile, so I would choose for him Lycopodium.

Miroslav, even though he could possibly be a Lycopodium?  Remember that etiology over-rules symptomatology!  The etiology here is quite clear!  He told us what his remedy was!  He said, “I went through allergy testing and it said plastic/petroleum products were the problem.”  What more could you ask for?  And then if you look up Petroleum in the materia medica, you get, “Skin of hands rough, cracked; Tips Of Fingers rough, cracked, fissured…” (Allen’s Keynotes) Sooooooo…….What can I say?  It’s hard to ignore Petroleum!  It just doesn’t get any clearer than this, I wish all my cases were this easy!

Jitka votes – Petroleum

This time I decided not to look for any tricks in the quiz but solve it straight-forward. Because Joe Schmo´s chronic complaints were caused by petroleum products, I think you prescribed the remedy Petroleum.

You are absolutely right!!!  When you think of Petroleum, you should always think of CRACKS!  If you learn nothing else here today, remember that Petroleum has CRACKS!

Petroleum – rubrics:

Extremities, chapped hands

Extremities, cracks skin, hands

Extremities, cracks skin, hands, deep and bleeding

Extremities, cracks skin, hands, winter, in

Extremities, cracks skin, fingers

Extremities, cracks skin, fingers, tips of

Skin, cracks

Skin, cracks, deep, bloody

Skin, cracks, winter, in

Skin, dry

Ear, noises, ringing

Although some rubrics are common for the Sulphur and such, I definitely chose Petroleum on the basis of this rubric:


-Chapped skin,

-cracked fingers,

– the tips of : Aur-m., bar-c., Graphites, Petr.


Here’s an update from Joe Schmo’s wife a month later:

“Elaine, he said his hands are good but he isn’t taking anything right now.  He said this is the best they have looked in years.”

And I just got another update today, this is May 19, 2015:

On another note, my husband had his Dr. App’t. yesterday and they checked his hands (which he [the doctor] has been doctoring for this issue for 20 years). They could not believe how good his hands looked.  We told them it was Petroleum 6C.  No response from them

Ha-ha!  Doctors hate us!!!!!!  So now, how about giving it up for our winners?




Wafee Samad

Wayne Butcher

Congratualtions, everybody!  See you back here again in June!  (Good grief! June already????)


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, 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 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"!


  • As usual nicely taken case and equally good explanation. You are really best teacher.
    Madam kindly suggest rubric in a case of a girl of 8 years . She is suffering from Psoriasis of scalp where there is no itching at all and complaint started within 6 months of change of her school. She has also unique habit of smelling everything like handkerchief, pillow, bedsheet etc usually when she is idle. She is thermally ambithermal.
    Main aetiologycal factor is change of school and leaving behind all her contacts. Kindly suggest rubric for the same.
    Thanking you

  • Thank you madam for your kind suggestion.
    Can Ignatia do good when the patient is ambithermal and Ignatia is chilly drug?


  • Many thanks for clearing the doubts by directing to quiz case. I will confirm Ignatia in the child when she visit me next week before giving it.
    Thank you

  • Respected Madam ,
    in the above case the girl patient did not visit me but her mother talked me on phone and I gave Ignatia 30 single dose. Yesterday i. e. after about 15 days her relative told me the girl patient improved dramatically.
    Many many thanks for intelligent guidance.

  • Really??? Wow! The psoriasis is gone? What about her habit of smelling everything? Anyway, it just goes to amplify our rule: Etiology over-rules symptomatology!

  • Thanks for replying.
    I have not yet talked to her mother. When I talk to her mother I will definitely enquire into her habit of smelling everything when idle.

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