To read last month’s full case quiz. Visit – I Feel Like Hell
OK! Who wants to go first?
Hey everybody, Vamsi’s in the house!!!!
Another brain-teaser quiz from you.
Yeah, read her case. I feel she is quite upset and depressed for quite some time.
Quite emotional, hysterical, desires to be alone, fear, anxiety, weeping
throughout the case. Cramps due to emotional reasons.
Reading through the etiology, I feel she would have been given IGNATIA.
Well, Vamsi, the first thing we have to do is make a list of the Elements Of The Case, all the things that are the most striking, strange, rare, peculiar or characteristic, all the things we would want to repertorize; look for words like “very” or “extremely”, or anything to indicate that a certain symptom was a big part of the case or very unusual, given the facts of the case… So, one of the first things we find is that she describes her pain as a 10 on a scale of 1-10; so, that’s quite extreme, don’t you think? So, the first thing I would put on our list is:
- Mind: pain, unbearable
Next, she says she was very nauseous! So, number 2 would be:
- Stomach, nausea, menses, during
Then she says she’s worried that the pains will come back, so I picked:
- Mind: fear, pains, fear of the
We could also pick “vomiting bile”:
- Stomach: vomiting, bile
She says she vomited 9 times in a row, which is quite extreme in my book; so, we could pick:
- Stomach: vomiting, constant
She was indicating that she was having diarrhea and vomiting at the same time, so we could pick:
- Stomach: vomiting, diarrhea, during
Now, here’s something peculiar. She said that normally she’d be lying down with a heating pad during her period; but, this time she was better from standing and walking back and forth despite how sick she felt! In fact, she said she was pacing back and forth from the bedroom to the bathroom. Very striking, in my opinion! So we could pick:
- Mind: restlessness, pacing back and forth
She said she’s crying, begging and praying; so, we can pick:
- Mind: crying, pains, with
- Mind: begging
- Mind: praying
- Food: Thirstless
She says the fact that she’s afraid to be alone is striking, not typical for her, so we could pick:
- Mind: fear, alone, of being
So if we repertorize these things, what do we get? Well, I tried posting my chart but it didn’t stick; so, you’ll have to take my word for it that Arsenicum covers the whole case!
What about all that stuff about how upset she was over the racist shootings in that South Carolina church and how sympathetic and empathetic she is, etc., etc.? It’s all meaningless, it has nothing to do with the case. If we were taking her constitutional case, it would be very important! But this is an acute case, a case of extreme pain, nausea, vomiting, diarrhea and fear during menses, and our job is to pull out all the elements of the acute case, add them up, and see what remedies come up for that. This was a perfect example of “Totality Of Symptoms”. There was no etiology to over-rule the totality, there was no peculiar symptom that made us have to think twice about using the totality because even the peculiars and the mentals–everything in the case–all went for Arsenicum!
Of course, the first thing you have to do, if a case has mentals, is make sure the remedy covers them! Well, no problem there, because all the mentals went for Arsenicum: fear, crying, begging, praying, pacing, needing company–it’s an Arsenicum album extravaganza!!
Elaine, that was a fabulous explanation. I really loved it to the core.
Thanks for all your time.
With deepest Regards,
Alright, will our next mystery challenger enter and sign in please!
It’s Wayne from Australia!
This case was a long-winded one!
Oops! Sorry about that!
I repertorised the following:
Grief, sorrow, general; ailments, from
I realize she said that she was very upset about the ignorant, racist shootings in South Carolina; but, what is the likelihood that that would lead to something resembling food poisoning? And then she said she wondered if this was a stomach virus on top of her period? That seemed like a reasonable possibility to me.
She said she didn’t want to be alone, but “isolation feelings” misses the mark. She doesn’t want to be alone out of fear. The illness is making her afraid.
Walking; general ; air, in open air, amel.
No, not open air, she wasn’t walking in open air, just pacing.
Heat; flushes of
Anxiety; menses during
I would prefer, “Anxiety about health”.
Vomiting, general; menses, during;
Cramping; pain, genitalia; uterus; menses, during
It’s better to use the “Female: dysmenorrhea” rubric because then you have access to all the sub-rubrics.
Company, general; desire, for
Top score was Pulsatilla.
I did get Pulsatilla in second place when I repertorized.
It seems to fit all the symptoms. Phosphorus was second, a bit lower on score and seems to have been tried without success.
Well, what you want to repertorize in this case, or any case, is anything that’s extreme or unusual for the patient, like if the patient says, “I’m normally not ________” or, “I never do ___________”, those are very important words! So in this case, what does the patient say is extreme and what does she say she’s doing that she normally never does? She says the pain is extreme, a 10 on a scale of 1-10; so, I picked “Mind: pain, unbearable”. She says the nausea is extreme, so I picked, “Stomach: nausea, menses, during”. She says that at one point she vomited 9 times in a row, so I picked “Stomach: vomiting, constant”. She indicated that she was vomiting and having diarrhea at or around the same time, so I picked “Stomach: vomiting, diarrhea, during”. (By the way, this really is hell, is it not? Yeesh!) Anyway, she says that normally when she has her period, she’s lying down with a heating pad, but this time, she was up pacing back and forth between the bedroom and the bathroom; so, I picked “Mind: restlessness, pacing back and forth”. There’s a lot of fear in this case, a lot of mentals that she says aren’t like her, and they are: begging, crying, praying, needing company (“Please help me, please help me, please don’t leave me.”) Well, ta-da! There’s the whole case for you! That one sentence: “Please help me, please help me, please don’t leave me.” That’s ARSENICUM! When you hear that? The case is over! That was all you needed to hear!
But meanwhile, everything else in the case is Arsenicum too! It’s under unbearable pain, vomiting and diarrhea at the same time, pacing back and forth, crying, begging and praying, it’s all there, it’s all Arsenicum!
Now, all the things you brought up about grief, etc., that’s information for the constitutional case, which we’re not interested in here. This is an acute case, so, we’re interested in all the ways she’s DIFFERENT from her constitution.
Elaine, thanks for your detailed reply and your time spent in replying. I love reading all this stuff, and learning from your experience.
I normally prescribe Arsenicum for food poisoning, especially for burning stomach, diarrhea and vomiting. You feel like dying.
I think I got onto the wrong etiology. I have never had a case with a period at the same time.
I don’t think there’s an etiology that will help us this time. She had her period so you might have thought all she needed was a cramps remedy like Mag-phos., and she made such a point of talking about the South Carolina shootings that you could have thought it was a case of Ailments From Bad News. But when she, herself, said, “Maybe I have a stomach virus on top of having my period,” that should move you away from those theories; at least it tells us that no one knows why she’s so sick.
I chose “Isolation” because she feels as if she does not fit in with the social beliefs of her community…
That’s right, but, that’s the constitutional case. You have to learn to separate the two out. Feeling like you’re surrounded by yahoos and morons, though exasperating, can’t possibly cause the kind of violent symptoms we see here.
And she seemed to bring them up as concerning to her.
Right, she did bring them up, and that raises an important point: Just because a patient says something during an interview doesn’t mean it’s worth repertorizing. Why might we ignore a symptom?
- It’s not part of the acute case, like if the patient reports being thirsty but she’s ALWAYS thirsty, or if a patient says she’s irritable; but, she’s ALWAYS irritable, then thirst and irritability would mean nothing to us.
- If it’s a common symptom of the disease, like if a flu patient reports having a headache, that would mean nothing to us, unless he had something more to say about it, like if it was a very severe headache and he had to lie perfectly still, unable to even open his eyes, it might confirm Bryonia for us.
- The symptom makes sense under the circumstances, like if our patient said, “I was so sad during my illness.” How would that help us? It’s normal to be sad during an illness. But if she said, “It’s strange, but, despite everything, I was feeling very calm and unruffled throughout the whole thing!” That would be very peculiar, and we would definitely want to choose “Mind: calmness” and it would surely rule out a lot of the anxiety-ridden remedies like Arsenicum and Aconite!
So when our patient says, “I have been so upset about the shootings…” and she’s going on and on about it, we can be thinking to ourselves, “She’s very empathetic, sympathetic, emotional…”; but, at the same time, we have to discern if any of what she’s saying is relevant, especially when she’s giving us one Arsenicum keynote after another; at some point, we have to admit that the center of gravity in the case lies in all the Arsenicum mentals piled high to the ceiling.
Thanks again, Elaine.
Hello, is the caller there? You’re on the air at Hpathy.com.
Hi, Anurag; sorry I kept you waiting.
I think the remedy shall be Ignatia.
No, see, this is where a lot of people got tripped up. Her grief over the shootings of 9 innocent people in a South Carolina church is a constitutional symptom. It tells us, “Maybe she’s a Phosphorus, maybe she’s Carcinosin…” I realize it threw a lot of people off. When she said, “My boyfriend had a stomach ache yesterday, maybe I have a stomach virus…” that should make us straighten up and change the direction of our thinking. If she had said, “I have been in tears, sobbing at the slightest provocation, ever since I heard about the shootings,” that would be a case for Ignatia. But we have to say to ourselves, “This case looks an awful lot like food poisoning or a gastro-intestinal flu” and, does that lead us to consider Ignatia? No, it doesn’t.
For rubrics, you have to look at everything in the case that’s extreme, and everything that she said was unusual for her, as in, “I never act this way, I never want to see the doctor, I never want to go to the hospital, I would never tell my family not to visit a relative in the hospital and stay here with me, I felt terrible about that!” and so on.
Who else wants to speak? Step up to the microphone.
Hello Elaine and Shana.
Oh look! It’s Miroslav and Jitka!
Here is our contribution to the August quiz.
Miroslav´s choice – Sepia
At first I was thinking about Pulsatilla, because of her demand to have people close around her.
But who else wants people close around her?
But Pulsatila would certainly have wanted to be touched, caressed, massaged … There was also her desire for cold air, but ultimately the patient was improved by warm bath. Also Pulsatilla is tearful, but the patient writes that she does not cry easily.
Wait a minute, I thought she was crying. “I spent the morning crying and wailing a little, praying ‘please help me, please help me’.”
Pulsatilla would probably not have dark circles under eyes …
I have excluded Mag-p. due to her desire for movement and the patient refused poultices … I was also thinking about Chamomilla, but apparently she wouldn´t be praying, but cursing and raging. She would be capricious and people should avoid her presence … So there still Sepia remains, actually it came out best from the repertory. Most of all I was captured by the fact that the female patient had a strong urge to expel something from inside at all levels. So my choice is this mostly female polychrest – Sepia.
Sepia is a big remedy in menstrual cramps; but, it doesn’t fit the mentals, and if there are mentals in a case, the remedy has to match them! Crying, begging, praying, wanting help, insisting that people stay with her even though they had planned to visit an uncle in the hospital; also, there’s the restlessness and pacing back and forth. Plus, we have a case that looks like a stomach virus on top of the usual menstrual cramps. Would Sepia cover a stomach virus? No.
Jitka´s choice – Ipecac
As for me this an acute case was a hard nut to crack. From most of all nominee-remedies I was comparing Pulsatilla and Sepia. I excluded Pulsatilla because she didn´t want to be touched or because she has not bright red blood in her picture, on the other side for me it was odd that Sepia wants to be fanned by cold air, she is not thirsty and so on. Although the most similar remedy came out Sepia on the base by my selected rubrics:
Genitals, female; dysmenorrhea; severe pain, crying and yelling: cact., coff, COLOC, cupr, CHAM, ign, mag.p., plat, sep
Genitals, female; dysmenorrhea; nausea and vomiting – IP, kreos, sars, sep, veratr.vir. (4 remedies)
Genitals;female; menstruation, bright red – IP, kreos, sep, (+ many rem.)
Genitals;female; cramps during – puls, SEP; (+many rem.)
Nevertheless, I would opt for another similar remedy and it’s Ipecac.
Genitals, female; dysmenorrhea; nausea and vomiting – IP is there
Genitals;female; menstruation, bright red – IP is there
– blue circles
– restless like Ars
Like Arsenicum? Why didn’t you pick Arsenicum???? When a case has mentals, and this case has plenty of them, you have to match them! What remedy says “please don’t leave”? What remedy begs and pleads for help, is restless, wants the doctor to come? What remedy is restless and paces back and forth? Arsenicum!!!!!
– mushy stool – nausea, vomiting, fainting
Maybe this is not a remedy that you prescribed for your patient, but I would probably chose it. I think it is quite similar.
It might have helped.
Ouch! I messed it up. I remember your scheme for “acutes” – sensation-location-modalities-concomitants- but I simply wasn’t able to evaluate her feelings because I eliminated Arsenicum immediately at the beginning of solving just for her troubles which started at 9:00 am, not at 1 a.m.
Oh dear. You know, I think the “aggravation time” only has true meaning if a pattern is set; for example, “4-8 p.m. is always my worst time of day”–Lycopodium. “My asthma attack always come on at 1 a.m.”–Arsenicum. “I always wake up between 2-4 in the morning”–Kali carb. I’m sure there could be exceptions, though. For instance, I remember one time I had some sort of digestive problem, I had an attack of diarrhea with a concomitant of fear, which I thought was very strange! I looked at the clock, it was midnight! I said, “Oh my God! It’s the Aconite aggravation time!” I took Aconite and got better.
You should read my “hierarchy of symptoms” article: https://hpathy.com/homeopathy-papers/acute-vs-chronic-remedies-the-hierarchy-of-symptoms-and-the-kitchen-sink/print/ I would never eliminate a remedy because the illness started at 9 a.m. You can’t make the time more important than the mentals, the peculiars, keynotes of a remedy, etc.; so, do read the above article on the hierarchy of symptoms, you have to know that to solve cases.
I had a bad day yesterday, I realized that I made too many grammatical and wording errors in my response to the quiz.
I didn’t even notice! But now that you’ve brought it up, I’ll make an effort to find all your mistakes!
Maybe your quiz should have a headline “Quiz for grammatical illiterates”… 🙂
It does have a certain ring to it…
Best regards, Jitka
I think we have time for one last contestant.
Hi Elaine and Shana 🙂
For this month’s quiz I vote for Colocynthis 200C because she tried it in 30th potency, it helped mentally but wasn’t sure about physically. If I am right, that tells us that it was correct remedy but needed higher potency.
So Colocynthis is my vote, if I am wrong I will try again.
Maria, could you copy and paste the part where she says she took Coloc. and it helped her mentally? Cuz I can’t find it. I found where she says she took it, but I don’t see it saying that it helped. I saw that she said she took Phosphorus and the stomach burning went away and she got more energy. But I don’t see her comment about Coloc.
Here it is: “when i took colocynths, my spirit felt better- a little relieved- i’m not sure it helped me physically, but it helped me emotionally-“
It is in paragraph number 7.
OK, I see it. Now, here’s the thing, Maria. In the scheme of things, you landed on a small, insignificant piece of the puzzle (that she was helped somewhat by Colocynth) and ran with it, while ignoring HUGE keynotes of a remedy that were total give-aways!
Two of the most important questions in my questionnaire are, “What are you doing?” and “What are you saying?” because look what she revealed here; she says she normally NEVER says these things–and that’s a big red flag, if a person says that–she says she was BEGGING people to help her, PRAYING and PLEADING with people not to leave her, and even wanting to go to the hospital, which is totally unlike her. She says that normally when she has her period she’s lying down with a heating pad, but THIS time, she was PACING back and forth from the bedroom to the bathroom! So what are the rubrics for these things?
- Mind: helplessness, feelings
- Mind: begging
- Mind: fear, alone, of being
- Mind: company, desires, while alone agg.
Now, what’s the rubric for “wants to go to the hospital”? The closest I could find was:
- Mind: impatience, behavior, cures him at once, the patient insists that the doctor (in other words: impatience, wants to be cured, insisting for the doctor to cure him at once)
- Mind: restlessness, pacing back and forth
- Mind: praying
And I should probably throw in one more very important symptom in the case:
- Mind: pain, unbearable
And when you repertorize this, what do you get? Arsenicum!
What a pity, I thought of Arsenicum actually immediately.
I believe you, it’s hard not to think of Arsenicum.
But as I mentioned above, this mental amelioration trapped me 😛
I know, and if the rest of the case had been vague, that might have been a good place for us to start; but, as it happened, it was literally buried by an avalanche of symptoms that went for Arsenicum, including ones we didn’t even mention like vomiting and diarrhea at the same time! And what’s missing here for Colocynth? Do we really feel comfortable giving Colocynth when the patient says she’s in terrible pain but never mentions being bent over double, which is the grand keynote of Colocynth? Abdominal pains that force the patient to bend over double; in fact, if you EVER see a person bent over double in abdominal pain, just give Colocynth right away without even thinking about it! If that doesn’t work, you can try its twin, Mag-phos.
You know, it’s funny, I have to tell you, Shana got her period yesterday, and by last night, it was awful, just awful! She was so sick! Terrible pain, nausea, vomiting, frequent bowel movements, headache, moaning and groaning…she just looked SICK! I said, “Ya know what? You look an awful lot like this month’s Quiz!” And with that I gave her Arsenicum 30C, though I never think of Arsenicum in menstrual cramps! But guess what? It worked! The headache went away, the nausea, the trips to the bathroom, the whole thing got better and she was able to go to sleep and wake up fine the next morning! But that is the Arsenicum picture–really sick! And the moaning and groaning, it just suddenly clicked with me! In fact, there’s a rubric: We always say, “You know what’s a useless phrase to a homeopath? ‘I feel sick’!” But, guess what? That’s in the Repertory! “Sick Feeling”. It’s in Murphy’s “Clinical” chapter. There are only 41 remedies and Arsenicum’s in bold!
So, I hope everyone’s learned something about Arsenicum today.
See you again next time!
Elaine Lewis, D.Hom., C.Hom.
Elaine takes online cases! Write to her at [email protected]
Visit her website: elaineLewis.hpathy.com