Case Quizes Clinical Cases

Revisiting: Hip Bones and Ribs and Chest, Oh My!

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Elaine gives the answer to last month’s painful quiz!

To read last month’s full case quiz. Visit – Hip Bones and Ribs and Chest, Oh My!



Rhus tox-7





How did we do this time? Who’s going to go first?

This one seems too easy, so I must be wrong (LOL)…but I just helped a friend with similar symptoms and this sounded so like “Rhus Tox” 🙂 (which my friend now thinks is a miracle) but her ‘spells’ are arthritic, and flare terribly this time of year in damp/cold.

The obvious things for me being the fever (alternating with chills) with great restlessness, bone pain, pain across temples (like board strapped across forehead) Better from heat/motion, pain in ears as if something was in them.. and of course being worse from wet weather/after rain, etc.

Natalie, you have fallen into my trap! What is the first question we ask in a case, what is the first thing we have to know?

Well, I guess I need to get into the habit of trying to discern ‘what’ we are dealing with. I was taught initially (and incorrectly) to just match the most symptoms (and weigh the odd/rare/mental ones more heavily). I guess I am too busy trying to match every thing you mention to a remedy.. 🙁

I am going to guess if we are dealing with a flu-type bug that Gelsemium might work? The mosquito bites threw me at first, then I saw where she lived (so figured it wasn’t an exotic disease carried by mosquitoes).

I am still having trouble because I have heard a million times that we don’t look at diseases or conditions, but just symptoms. I think I am understanding that you DO look at the big picture, and what you are dealing with, as opposed to playing a ‘match game’.. 😉

The thing is this: symptoms go for many conditions. Take diarrhea, for example. There must be a dozen or more conditions that have diarrhea–from stomach flu to fear of public speaking. Now, if it’s stomach flu, we might be thinking of Arsenicum. If it’s fear of public speaking, we’d be thinking more of Gelsemium and Argent-nit. Consequently, the first thing we need to see is “the big picture” or as Hahnemann used to say, we have to perceive what has to be cured. We have to identify the context these symptoms are occurring in. So what IS the first thing we want to know? The CAUSE, also known as the etiology, or, in our Repertory, “Ailments From”. What caused this person to get this list of symptoms? What happened to this patient? Now, of course, if the answer is too general like “germs” (he caught so-and-so’s cold) it doesn’t help us much. But sometimes the etiology is very well-known as belonging to a remedy, like: ailments from cold/dry winds, ailments from blunt trauma, ailments from bad news, ailments from disappointment, ailments from anesthesia, etc. These things really orient us!

You also know to look for what is striking and peculiar in a case, as per paragraph 153 of the Organon, right? To me, what was striking and also appeared to be the etiology here, was exactly what Lucy said, that there were mosquitoes everywhere due to all the rain and standing water, that as soon as she walked outside, there they were, swarming all over her! She said she had never seen anything like it in her life, it had never been this bad! She’s drawing our attention to where we need to look.

Enjoying the articles as always, but always go for yours first.. 🙂 Have a wonderful Christmas!

Thank you!



Will our next contestant enter and sign in please!

Hi Elaine,

Hoping to be the 1st one to answer this time again for your quiz:

So much of aches everywhere in the body, restlessness, better from movement and heat, raining continuously make the case appropriate for Rhus-Tox.

I hope you would have cured the patient with the same.

Thanks for acknowledging!

Well Anurag, you are the 2nd person to answer this time, AND, you are the 2nd person to vote for Rhus tox, AND, you are the 2nd person to be wrong!

Oh! But I am sure I will not be the last one to guess Rhus-Tox

You must be psychic!

…as it is so well depicted with the available facts.

I can understand why you voted for Rhus tox, but, what is the first question we are supposed to ask in a case?

The first question? You mean “etiology” ?


So are you pointing out to mosquito bites?


That means “Ledum Pal” ?

YES!!!!! 🙂



In India every other person is affected by huge mosquito bites specially due to rain.

Has anyone ever thought to give these people Ledum pal? I take Ledum just for the itching of mosquito bites, and it works!

How can we put this as the main symptom for all the problems?

What are you saying, that the different symptoms can or should over-rule the etiology?

But since it cured your patient, I do need to defer to you!

Good idea!




Who else is here? Wayne Butcher from Australia, come on down!

Hi Elaine,
I never repertorized this one. I have a feeling what it is and confirmed it with Robin Murphy’s Materia Medica.

Wow! I can’t wait to see what you came up with!

Deep seated aching in bones, insomnia, headaches, earaches, alternating heat and chills, droopy eyes, probably influenza.
I think it is Gelsemium.

A good guess, but wrong. When you said you didn’t repertorize, that you just had a feeling, I had high hopes, because I didn’t repertorize either. Tell me, what is the first thing we need to find out in a case?

The first thing to look at is etiology,

Yes, you are right!

and considering the rain and mosquitoes in the environment, I surmised that the cause of the problem is a mosquito borne disease.

Good thinking!

In Australia, we only have two of these mosquito diseases, Dengue Fever and Ross River Virus which has symptoms similar to your patient’s case, but can last some months according to the allopaths – it drains people.
I see in the repertory a reference to marsh fever.
I repertorised as follows:
Alternating fever with chills
Marsh, fever
Close, eyes, general involuntary
Restless, sleep
Heaviness; sensation; internally
Pain; general
Sinusitis, infection, nose, headache, from sinus catarrh.
My top remedies were Rhus Tox, Arsenicum, which had been tried, and China – a malarial remedy.
Looking at the modalities it would appear that Rhus Tox would be the right remedy, Worse from rainy weather, Worse exposure to wet, Better stretching limbs, continued motion, Better warmth.
What is your opinion on giving remedies based on the 3 legged table or 4 legged table method. i.e. using Boericke’s or Phatak’s Repertories and selecting remedies which occur either acccording to 3 or 4 symptoms in those repertories?

You repertorized everything but the etiology–after acknowledging that that was what was the most important thing in the case! So, did you decide what the etiology was? You said the patient appeared to have a mosquito-borne disease; so, that’s “ailments from mosquito bites”, right? So, if you have Murphy’s Repertory, 3rd ed., go to the Clinical chapter and scroll down to Bites, and then subrubric, Mosquitos, and you see there are only 3 remedies–Ledum, Caladium and Staphysagria. So, when you are down to three remedies in a case? Just give one! (Which is what I did.)

So, the amazing point being, and I know this is hard to believe, when you know the etiology, none of those symptoms matter! If you don’t believe me, ask yourself, who repertorizes an Arnica case? Someone falls and hits his head, what do you do? You give Arnica! Do you take the case? Do you say, “What’s the sensation? What makes you better or worse?” No! Why? Because you know the etiology! Ailments from blunt trauma, and what is the remedy for that? Arnica!

Now, having said that, there is not always a clear etiology, and even when there is, there are often a number of remedies to choose from, making your choice harder. But when you do have a clear etiology, and it’s a small rubric? Rejoice!

Happy 2015,

Same to you!

Wayne Butcher


Shall we go to the phones? Hello! Is the caller there? You’re on the air at

Hi Elaine and Shana

Hi Maria!!

For this month’s quiz I vote for Rhus-tox. The spine, joint, ribs pain, the tossing and turning, the heat and movement amelioration, the possible damp weather aggravation I think all fit.

I don’t think the etiology is the mosquito bites, since it happened 2 days before. It could be though and in that case I will vote again 🙂

It is, so vote again! (P.S. “Lucy” didn’t say she was bitten two days before, she said that two days before, a bunch of baby mosquitoes hatched and every time she leaves the house, they swarm all around her.)

Oh I did not translate correctly then.
Ok, then my vote is for Ledum

Yes, you got it!!!!!

since etiology over-rules symptomatology and that is a lesson I learned in another mosquito bite quiz where I voted wrong 🙂
But if I am not correct I will try again 🙂

No, take the rest of the night off!

Ps: Happy new year, happy quizzes and happy patients!

Thanks, same to you!!!


Look who’s here!  Gabi from Canada, come on down!!!!!

Hi Elaine!

Hi Gabi!

I say it’s Rhus tox for the quiz but i could be wrong.

That’s what everyone is saying, but, what is the etiology?

If we think that it started with the mosquito bites, then it’s LEDUM

You are correct, Madam!

(OK, so a lot of you knew the answer, you just didn’t know that you knew!)


Hey everybody, it’s our pals Miroslav and Jitka!

Dear Elaine and Shana,

first we wish both of you good health, happiness and success in the coming year and always.

Thank you!!! Same to you!

Here are our answers on a December quiz.

Miroslav says:

The case looks like Rhus-t., but one symptom doesn´t match: she is apathetic

Actually, no. She did say she felt “lethargic”. Apathy is a mental state, lethargy is physical. The fact that she can’t sleep might explain the lethargy. Here’s what she wrote:

I am physically restless, cannot sleep, cannot get comfortable. My eyes are droopy. Mentally, I feel fine, balanced – not worried or upset.

Just this one symptom doesn´t match, else has all symptoms of Rhus tox. Eyes, closed, (inability to open them) , it is my favorite Rhus-t. So I would administer Rhus-t in such case I was thinking about Dulcamara as a remedy No.2. I excluded Eupatorium as there is no mention about aching in every bone…

Actually, she does pretty much say that she has aching in just about every bone in her body…

Jitka´s guess is Natrum sulphur.

A quote from J.T. Kent´s – “Lectures….”:

“Natrum sulph. stands out prominently as a remedy where all the conditions are worse from dampness.“

Mosquitoes = malarial influences. It is useful in patients who live near waterways and have suffered long from malarial influences Very sensitive to pain. The pains are very numerous; dull pains, sharp pains, all better from motion. Complaints all worse in the spring and in warm weather. General, physical restlessness and anxiety. Marked weakness and trembling with internal pulsations and rapid heart. Twitching of muscles. Complaints from injuries of head and spine. The symptoms all worse during rest.

OK! Well, good guesses, but, before we do anything, we have to ask yourselves: What is the etiology?

We both worked the case on our own, but we both perceived that the etiology is dampness in this case. We thought firstly about Dulcamara and Rhus tox. While Miroslav focused on Rhus tox because of significant restlessness, I refused Rhus tox because of the cold application that ameliorated.

Good point!

On the grounds of ” droopy eyes” fever, headache, sleeplessness and summer sickness I chose Gelsemium. Miroslav argued that the patient is too restless to be Gelsemium.

See, now you’re getting to the heart of the problem; namely, there is no clear remedy picture in this case! It is at this point that you have to think about etiology or an auto-nosode.

To me, this looks like some weird tropical disease! Alternating heat and cold? Chills? Fever? Bone pains? Headache? To me it’s like the mosquitoes are carrying some disease! She made such a point of saying, “Mosquitoes, so many mosquitoes!” I had to go with that! So, I picked “ailments from mosquito bites”–Ledum!


We just about have time for one more caller….Hello! You’re on the air at!

Hi Elaine, it’s Claire; ready to answer your quiz, (hips, ribs, chest) was it Gelsemium?

No, though I did get another vote for Gelsemium. What’s the first question we generally ask in a case. “What happened? What caused this?” so we can check our “Ailments From” rubrics. So, what do you think happened here?

I’ll look back at it again and take another stab at it; I thought Gels when she said lethargy and droopy eyes.

But did you notice she had symptoms for over half a dozen remedies? We have no remedy picture here. I can see, in this case, Kali bich, Eup-perf, Rhus tox, Pulsatilla, Gelsemium, Mercury, Arnica, Nat-sulph … which should tell us it’s not gonna be any one of those remedies! And there are no “mentals” so we can’t go on that either. We’ve gotta look at the etiology. An auto-nosode would be another thing to keep in mind.

She was saying something about humidity and rain, and getting bit by a lot of mosquitoes…. but yes, I remember first learning of the importance of etiology from an interview with Dr. Luc — and you?

Yes, moi. Granted, there’s not always an etiology, but sometimes, knowing “what happened?” can be crucial information.

So when someone has complaints that seem like a whole slew of remedies, you should look elsewhere, like etiology, ailments from, etc?

Clearly, what we don’t have here is a remedy picture! When we have a confusing picture like this, we want to look at what’s causing this. Sometimes you’ll see that these are the side-effects of the drug the person is on, so you’d want to make a remedy out of the drug; or, maybe some strange bacteria is infecting him which he may have picked up during a dental cleaning, for example; in which case we might be looking to make an auto-nosode out of the person’s blood maybe; but, what do you think the cause is here? I had to go with mosquito bites since she made such a point of how insane the mosquito situation was.

Argh! I thought about Ledum but I guess in the end she was describing all the other stuff, and so I ignored “ailments from bites”. Oh well!

I gave this quiz to teach people that symptoms get pushed to the side when you know the etiology!  But of course, we don’t always have an etiology, or it’s too remote, and even when we do, there are often too many remedies in the rubric to make it helpful to us (ailments from the sun, for example; or, ailments from the cold…).

So, “ailments from” is more important than the totality of symptoms?  Interesting!  So were all her symptoms just her particular immune response to being bitten by a ton of mosquitoes, perhaps?  It seemed like a lot of severe symptoms.

Clearly, all her symptoms were irrelevant in terms of finding the remedy!  I don’t know what they meant or why being bitten by mosquitoes would cause them; or if the mosquitoes were carrying some disease the way they carry malaria?  Quite possibly, but, what’s interesting is, if someone gets sick after being bitten?  They need an “Ailments From bites” remedy!  Everyone seems to know about the “totality of symptoms” and how important that is, which is fine; but, the etiology can over-rule ALL the symptoms in a case if it’s clear and recent; or what are the “ailments from” rubrics for? 

Well, no right answers in the strict sense of the word this time, Dr. B; but, Maria came very close by saying she “translated wrong”; so, do we give Maria the benefit of the doubt?  You know what?  Shana and I are going to see Gene Chandler on the 24th, do you know what Gene Chandler said back in 1966?  He said, “I fooled you this time, the last laugh is mine….”  This is for you, Maria!

See you next time!


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

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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