Case Quizes Clinical Cases

Revisiting: Flu Threatens to Wash Up Plans for the Beach

Elaine gives the answer to last month’s quiz. Revisiting: Flu Threatens to Wash Up Plans for the Beach

Mom! Come on we’re late for the quiz!!!!

Shana, you do it; I have to get ready for my 45th high school class reunion! (YAY class of ’65!)

Well, I have to get ready for my prom!

Shana, there will be another prom next year, but there will be only one 45th annual high school class reunion for me, and I have to hem my blue jeans!

All I can say is, it’s a good thing this patient filled out the questionnaire! Here it is everybody, you’re just going to have to read it for yourselves!

Shana, what are you doing? You can’t put on pantyhose like a pair of socks!

Why not?

Please excuse me.  Start reading the case!



1. Describe the complaint or complaints in your own words in as much detail as you can. Don’t forget to include the onset–did the complaint come on suddenly or gradually?

— gradually

2. Etiology–this means the cause, if you know it.

— the flu…

What was going on at, or around, the time of the occurrence?

— feverish, sore throat, sneezing

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

— sensation as if all the bones are broken and tiredness

Does it extend anywhere, does it shoot anywhere?

— headache on left side, as if a nail was fixed in the left eye

4. Appearance– anything remarkable?

— droopy eyes and Just want to lie down

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

— (no response)

6. Modalities

— Worse: drafts, warm rooms, motion, at 10:00PM to 02:00 AM, consolation, noise, heat

— Better: music, bathing, fresh air, drinking fruit juice, água-de-coco, laying down

7. Concomitants

— stomach ache, belching, slow digestion + swollen tongue with teeth marks on the sides, lacking sensibility

8. Discharges–color, odor, consistency

— Stool – bad odor, dark

— urine – dark, strong odor and hot

9. Generals

— not thirsty; tired, hoarse, nasal voice, I’m coughing

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

— irritability, confusion, dullness, apathy

11. What have you been saying?

— leave me alone

12. What are you doing?

— Coughing, changing place, trying to sleep

13. Describe your thirst and appetite

— decrease in appetite, not thirsty, fresh gulps drinks, infrequently, craving salty

14. Fever?

— at the beginning

15. Sweating?

— a little

16. Odors?

— bad breath in the morning and before bed (late night)

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

— long-lasting

18. Is there a diagnosis?

— flu

19. Describe your energy

— tired, prostration


Elaine, I took _________________200C like you said. WHAT A RELIEF!
Finally I slept well last Thursday after the dose, yesterday I repeated the dose and spent the whole day very well and last night the same, a good and well sleeping night.
I decided to go to beach for the weekend and I’m even better here, the air of the beach makes me feel really good. Almost healed.

Thanks Elaine.
Have a nice weekend.





Eupatorium perf.-2




And the winner is…….(envelope please!)  Gelsemium!!!!!!!

Why can’t it be Nat-mur?  Everyone thought it was nat-mur (craves salty and wants to be alone). Problem is, nat-mur isn’t a flu remedy!  I was having to explain the same thing to Sujatha just a few days ago.  Here’s what I said:

Sujatha, it is like this. For every major or common illness, like the flu, or measles, etc., we have what’s known as a “differential”.  A “differential” is a list of remedies which commonly treats that ailment.  A flu differential would look something like this:




Nux vomica




Rhus tox






Hopefully, I haven’t forgotten any of the main ones; but, the question then becomes, how do you differentiate one remedy from the next?  The answer is by learning the keynotes of the remedies. Keynotes are the things that a remedy is FAMOUS for:

Gelsemium is famous for the five d’s: Droopy, Drowsy, Dopey, Dizzy and Dull.  Also, thirstlessness, chills in the spine area, and APATHY!  The Gelsemium person just does not care and may seem trembly, shaky, weak-kneed and stuporous.

Eupatorium perf feels like all his bones are broken, he is also thirsty.

Arsenicum’s keynotes are: thirst for sips at a time, ANXIETY, need for company/hand-holding/constant reassurance, restlessness, fear of death and being alone, chilliness, diarrhea, weakness and prostration.

Nux v. patients are irritable and impatient, usually have a stomach flu and are very chilly.

Baptisia is a Gelsemium with thirst.  Baptisia also has very bad odors.

Bryonia has a very bad headache and unlike Arsenicum which is restless, simply cannot move without feeling worse; so, he lies perfectly still and will not answer questions.  He is very thirsty and will drink a glass of water down.

Arnica feels as if hit by a truck, very sore, and the bed feels too hard.

Pyrogen also feels the bed is too hard, can’t get comfortable; also has bad odors.

Rhus tox feels the need to move and stretch, is worse for lying still.  May say he feels soooo much better after a hot shower.

Mercury is famous for excessive salivation/drooling, sweating, bad breath, and NARROW RANGE OF TEMPERATURE TOLERANCE, which means the Mercury patient is constantly throwing the covers off and putting them back on again!  Despite the excessive salivation, they are thirsty.  (However a word of warning:  Some of your patients with sore throats may not be able to swallow!  Because of that they may drool out of necessity.  This is not the same as excessive salivation!)

When the symptoms don’t seem to point to any remedy in particular, or you’ve tried a number of them with no results, go for the nosodes–Influenzinum and Oscillococcinum.  Basically, having an acute prescribing book would be ideal for such times, and going alphabetically to your illness, going down the list, and seeing which remedy best matches your case.

And so, hopefully, you can see here that we do not repertorize a flu case, because we are NOT starting from the premise that it could be any one of 3,000 remedies; we are starting from the premise that it is probably one of a possible 10 or 15 remedies!  And all we need to do is look for the famous symptoms of the remedy in the case, and voila! we’re done.

Sujatha then asked where she could find a collection of differentials for various ailments.  These are to be found in our acute prescribing books, of which there are many; but, our own hpathy ezine editor, Alan Schmukler, has written one (Homeopathy an A to Z Home Handbook).  If you go alphabetically to “flu”, here’s what Alan says under Gelsemium:

“Looks drowsy or intoxicated with drooping eyelids and flushed face.  Limbs feel heavy WANTS TO BE LEFT ALONE. Chills up and down the back.  No thirst during the fever.  Pain in the eyeballs or the back of the head.  Pulse slow.”

So, you can see what happened.  People saw “wants to be alone” in the case and went right to nat-mur when they should have gone right to the “flu” in their Repertory or acute prescribing book.  Do you see that?  Let me explain it this way: Let’s say you want to visit somebody who lives in the United States.  All you know is that the person lives on Main Street so you go to MapQuest and look up Main Street.  Is that smart?  Does it make any sense?  Do you have any idea how many cities in the US have a “Main Street”?  What do you have to know first?  The state the person lives in, like Florida, for example, and then the city, like Orlando!  NOW you can look up Main Street–at the end!

This is why we have a hierarchy of symptoms which I always talk about.  Right at the top of the hierarchy should be “What do you have, what is wrong with you?”  If you don’t know that, you won’t know what chapter of the repertory to look in (“Florida”) or what the primary rubric might be (“Orlando”).  Similarly, you won’t know what topic to look under in your acute prescribing book.

If the patient’s complaint was “Depression” instead of “Flu”, then Nat-mur would surely be right there at the top of your list, as it’s part of our “Depression” differential, and “wants to be alone” would be a great differentiating sub-rubric; you’d know it wasn’t any of our “better company” remedies for sure: Phosphorus, Arsenicum or Pulsatilla!

Now, regarding the other remedies you voted for….

Why can’t it be Bryonia?  The patient is thirstless.

Why can’t it be Eup-perf.?  The patient is thirstless.

Why can’t it be Arsenicum?  The patient is thirstless.

Why can’t it be Mercury?  The patient is thirstless.

Do you see how easy it is to work with a differential?

Here’s what one of our winners, Dr. Nishita Gupta, had to say:

I think I am too late to reply this time….I am sorry for that.

Anywayz I think GELSEMIUM 200C is the apt remedy as this case presents all the symptoms of gels. Right from the beginning it is pointing towards gels……….firstly gels is a great flu remedy………then dullness in mind……… thirst………….gradual onset………..tiredness with broken feeling……….droopy eyes……..worse warmth……….everything as per me is pointing towards gelsemium…………….hope I am correct, fingers crossed!!!!!

So now let’s congratulate our winners:

Maria Theodorou from Greece, and Dr. Nishita Gupta, from…. I’m guessing India?  See you all again next time!!!!!

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


  • This is an excellent article. We usually do not go into details of thirsts.It plays a very important role in prescribing. One blames homeopathy for self mistakes. HATS OFF to dr Elaine for making homeopathy look so simple.She has command on differetiating the remedies.
    We would also like to see a chronic case treated by Dr Elaine.She is an expert in acute cases

  • Dear Usman Ali Khan,

    Believe it or not, people do not, as a rule, know how to treat acute cases–which is a disaster! If we knew how to stop acute suffering, even people with chronic disease would be greatly benefitted!

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