Clinical Cases

Revisiting: I Cant Believe Its Not Butter!

Written by Elaine Lewis

Elaine gives the answer to last month’s quiz. Revisiting: I Cant Believe Its Not Butter!

Let’s recap last month’s Peabody Award-Winning Quiz for our audience:

Kelly DID finally surface–


briefly; and said something about soccer and vanished into thin air….Luckily, Inez got sick again!

So, now, I give you the second episode in our exciting dramatization of, “I Can’t Believe It’s Not Butter!”

Acute Case Questionnaire

1. Describe the complaint.

Inez has swollen tonsils and a fever of 100.6.  She said at school yesterday that she was not feeling well then slept (uncharacteristically) at nap time for over an hour.  She woke with the tonsils and developed a fever by the time we got home (15 minutes).  She has slowly been losing the stuffy nose and cough that were left after her last bout of tonsillitis (?) about 3 weeks ago.

2. Etiology–

Much illness at school.  Assorted colds, fevers, sore throats, etc.  It has become quite cold for our temperate climate, so we are inside more than usual.  I think her tonsils are Inez’s weak spot, her line of defense against illness.  If she gets sick, they will be the spot where the illness shows most.

3. Sensation–

It feels like knives in her throat.  While eating, drinking and while just sitting.

4. Appearance–

She is pale-ish.  Her throat looks exactly like last time: tonsils touching, slightly red with a dark red streak running through the right side.  No white spots.

5. Location

Throat, tonsils. She says her whole neck hurts.

6. Modalities–

She says she can’t lie down, her neck hurts if she does.  She must sit up.  I think her tonsils are so swollen that she feels anxious about lying back, her breathing may be impaired some.  Her voice is certainly thick sounding.

7. Concomitants

She has a few itchy spots on her legs and one on her arm.  They look like bug bites that she has scratched open.  They are slightly red and bumpy around them.  Not spreading to any other parts so far.  She was itching in the night 2 nights ago, the night before she got sick.

8. Discharges–color, odor, consistency.

No runny nose, no sweating, very light colored and small amount of urine when she woke this morning.

9. Generals–

Not much here, just I don’t feel good.  I don’t want to go to school.  She did say that she should stay home so that she didn’t get her friends sick.

10. The mentals:

Droopier than usual. Knitted brow, a little anxious.  Wants company

11. What does the person say?

‘No, I’m ok.”  When I offered her anything to eat or drink last night she just kept saying that.  She did eat of all things at the meal, roast beef, a typical favorite of hers.  Today she has had only a scrambled egg and a small glass of limeade.

12. What is the person doing?

Sitting up still in bed.  Quietly watching Sesame Street, she now wants company.  “I want some company” are her exact words.

13. Fever?


14. Sweating? 


15. Odors?

Thick stale breath.  She hasn’t brushed her teeth since yesterday morning.

16. What is most striking about the condition or most peculiar–

Like I said, this seems very like her bout with sore throat 3 weeks ago but I have twice given her Pulsatilla 200c since last night to no real effect.  Last time her tonsils immediately shrunk and the fever subsided.  She did have a lingering cough and stuffiness though.

She is not interested in any food, not even butter, which I jokingly offered her last night to which she answered in all seriousness: “No, I’m ok.”

17. Is there a diagnosis? 

Probably strep throat again.

18. Describe the patient’s energy–

Quiet. Wants company but is sitting still in bed. She is a bit anxious, her brow knits and she looks at me plaintively when I cuddle her.

19. Thirst–

Not thirsty.  Wants small sips of cold water infrequently, I have to offer the water.


Let me begin by saying that after giving the remedy, Samantha wrote and said, “I only had a 30X but her fever dropped immediately.”

When we look for remedies in acute cases, three words immediately jump to mind:



Modalities (ameliorating and aggravating factors)

What we got here was a “sensation”–pain like knives and at least one modality–worse lying flat.  The sensation can be found in, “Throat: tonsils, general, sharp, pain, tonsils”–there are only two well-indicated remedies, Belladonna and Mercury.  Since she’s not sweating and not thirsty, there goes Mercury!  Belladonna is famous for being worse lying.  Also, remember–the fever came on suddenly! She had a fever 15 minutes after waking from her nap.  Sudden onset of fever is a grand keynote of–ta-da!– Belladonna; and then we have the Belladonna thirstlessness as well.

Now, here’s what’s interesting about the last two quizzes: The same child, the same illness, the same diagnosis, the same symptoms, but, TWO DIFFERENT REMEDIES!  How is that possible?  It’s mind-boggling, isn’t it?  You can see why it’s so difficult to practice homeopathy!  Who would believe you couldn’t just give the same remedy that worked the last time?

The reason is because we are looking for what’s PECULIAR or characteristic in a case!  I think Inez may become our “poster-child” for Aphorism 153 of the Organon–the “Strange/Rare and Peculiar” clause.  In the first quiz, we had a very peculiar symptom–she was eating butter off the stick!–covered by just two remedies–Mercury and Pulsatilla.  This was absent from the second case!  In the second case, we had a characteristic sensation (pain like knives), sudden onset and worse lying.  The acute case questionnaire I send out, which you can see above, is designed to elicit this kind of information, that’s why no matter how much you tell me about your case, I STILL need you to fill out the questionnaire! Truly, we do not treat diseases, we treat people.  Now, I must say, Katie wrote in and gave a rather loooong explanation for why it’s Belladonna, so, in deference to all her hard work, heeeeeeeere’s Katie!

Hi Elaine,


I have tended to repertorize on paper and I missed a lot this time doing it that way.  I do have the “Hompath” software and have been trying to learn to use it.  After crashing on my first, manual attempt at the November quiz, I spent some time getting more familiar and at ease with Hompath – thanks for nudging me in that direction.

I did? How nice of me!

The rubric choices are making more sense now, too.

Using Hompath’s Complete Repertory, Belladonna scored the highest and fit to some degree all of the following rubrics (although I would have expected a Belladonna fever to be higher and the child to be less stoical):

Children never do what you want them to do!

* Mind/Quiet:Disposition
* Mind/Anxiety
* Mind/Company:Desire for
* Gen/Lying: Agg
* Gen/Sudden manifestations
* Gen/Side: Right
* Gen/Discoloration: Redness: Streaks
* Gen/Discoloration: Redness: of Affected parts
* Throat/Pain: Lancinating
* Throat/Swelling:Tonsils
* Throat/Discoloration: Redness: Tonsils
* Stomach/Thirstlessness
* Fever, Heat/Heat in general

That’s great, Katie, but, you really worked harder than you needed to!  Remember my article “Acute vs. Chronic Remedies, the Hierarchy of Symptoms and the Kitchen Sink”? (Catchy title, isn’t it?) Well, in it, I list the hierarchy of symptom-types we use to evaluate the symptoms in a case.  At or near the top is “onset”.  If you’ve got a case with “sudden onset”, you’re practically home free, down to three remedies before you even start: Belladonna, Aconite and Baptisia.  Aconite and Baptisia are thirsty, Belladonna’s not.  So,  bam!  Case closed!  And then you just ask yourself, Does Belladonna have sharp pains?  Yes.  Does Belladonna have right-sided complaints?  Yes.  Does Belladonna have red streaks?  Yes.  Does Belladonna have fevers?  Swelling?  Worse lying?  Yes, yes, yes!

The disposition really wasn’t worth commenting on nor repertorizing.  The desire for company in a four-year-old child?  Normal.  Don’t repertorize symptoms that are mild or normal.  Now, if you have a sick child who wants to be alone?  Wow!  Boy is that symptom important!  Or a sick child who just doesn’t care if you leave the room or doesn’t call you to come to the room!

And since you mention Belladonna, you may want to hear about MY Belladonna case, a cold that I just recently got over.  But first before I forget, let’s congratulate our winners–Patrizia Chand, Katie and G. Vijayakumari.  I’m sure Dr. B has a nice prize for you.

Now as I was saying, this was the first cold in a long time that really got away from me.  I usually nip them in the bud with an immediate dose of Ferrum phos. 30C, but somehow…I must have gotten run down from lack of sleep.  Shana got it first and she was coughing in my face for days!  Then, the next thing I knew, I had a sore throat.  There were no peculiar symptoms to prescribe on, no modalities, nothing characteristic.  Then it started moving down into my chest and I was coughing.  After a couple of days of this, finally a peculiar symptom showed up: expectoration that had a bloody taste to it!  I had never experienced that before, so I thought if I can just find this in the repertory, I’ll be home free!  Sure enough, amazingly, it was there!  Murphy’s repertory, “Taste: bloody, coughing, when”–two remedies in bold: Rhus tox (which I had already tried) and Belladonna.  I said to myself, “Gee, I don’t recognize this as a Belladonna state–no fever, no redness, nothing typical of Belladonna, and it’s not even early in the case when you’re supposed to see Belladonna; but, there it was, so I thought I might as well try it!  Well, thank God, because I hadn’t been able to sleep the night before because of this cold, but the cough stopped right away and I went right to sleep!  So, there you go, a peculiar symptom solves the case once again!

This month’s song goes out to Belladonna: “You’re My Remedy” by The Marvelettes!  See ya next year!

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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